What We Know About the Peer Workforce and Economic Evaluation for Peer Recovery Support Services: A Systematic Review

Area of Science:

• Health Services Research
• Substance Use Disorder Treatment
• Health Economics

Background:

• Peer recovery support services (PRSS) for substance use disorder (SUD) have expanded significantly, with formal certification and Medicaid reimbursement in most US states.
• Despite increased research, critical gaps persist regarding the peer workforce and economic evaluations of PRSS.
• This systematic review synthesizes current literature to address these knowledge gaps.

Approach:

• Systematic review following PRISMA guidelines, with a registered PROSPERO protocol (CRD42022323516).
• Included peer-reviewed articles, dissertations, conference presentations, and evaluation reports.
• Manuscripts were categorized into workforce development and/or economic evaluation parameters.

Key Points:

• Twenty-two manuscripts focused on the peer workforce, detailing peer characteristics, service delivery, and training outcomes.
• Twenty-six manuscripts provided economic evaluation parameters, primarily service utilization costs and peer worker compensation.
• Effectiveness parameters were mainly substance use-related, with limited data on quality of life or life functioning.

Conclusions:

• Future research should investigate the links between peer job satisfaction, tenure, and patient outcomes.
• Consistent outcome measures, particularly for quality of life and life functioning, are needed.
• Addressing these gaps will strengthen the evidence base for PRSS effectiveness and economic value.