Peer-Mentor Support for Older, Vulnerable Patients With Ischemic Heart Disease: A Mixed Methods Process-Outcome Evaluation.

This paper reports exploratory ancillary findings, not the primary RCT efficacy analysis. The qualitative sample was small: 13 mentees and 12 peer mentors. Interviewees volunteered for peer support and cardiac rehabilitation, so they may be more motivated than the wider post-MI population. The study took place during the COVID-19 pandemic, which may have affected interactions, participation, and outcomes. More mentees than controls were offered community-based cardiac rehabilitation, so differences in commute may partly explain attendance results. The mentor intervention included matching, training, supervision, and contact over 24 weeks, so the effect of any single component cannot be separated. Satisfaction and overall effect were self-reported by mentees in the intervention group. The dietary measure may not be sustainable or sensitive enough, because only a small number of general population can achieve heart-healthy status. Physical activity results changed with the threshold used, so the chosen cut-off influenced the outcome. Older, vulnerable patients were selected, so results may not apply to younger IHD patients.

The authors declared no conflicts of interest. The study was funded by Velux Fonden.

Do not conclude that peer-mentor support alone caused better cardiac rehabilitation attendance or improved lifestyle and psychological outcomes. The primary RCT showed no significant effect on anxiety, depression, quality of life, diet, self-efficacy, or physical activity, and more mentees than controls were offered community-based cardiac rehabilitation, so easier travel may also explain attendance.