Only 198 articles were found over a 10 year period which demonstrates the limited published research on highly prevalent diseases in LMIC. Most studies reported interventions by non-specialists (n=86 43.4%) and multidisciplinary teams (n=49 25.5%). Studies included related to the following topics: description or testing of interventions (n=81 41.3%), implementation or evaluation projects (n=42 21.4%), quality improvement initiatives (n=15 7.7%), screening and prevention efforts (n=26 13.2%), management of HTN or DM (n=13 6.6%), integrated health services (n=10 5.1%), knowledge and attitude surveys (n=5 2.5%), cost-effective lab tests (n=2 1%) and policy making efforts (n=2 1%). The strategies focused on healthcare service organization (76.5%), community level (9.7 %), creating a positive policy environment (3.6%) and strategies covering multiple domains (10.2%).
The Innovative Care for Chronic Conditions Framework (ICCCF) was used to guide analysis and reporting of results. Key extraction variables included the 12 criteria identified by the Template for Intervention Description and Replication (TIDieR) checklist and guide. Interventions covering health promotion, prevention, treatment, or rehabilitation activities at the PHC or community level were included. Studies published in English, French, Portuguese and Spanish, from January 2007 to January 2017, were included.
Two reviewers conducted an electronic search of three databases (Pubmed, EMBASE and Web of Science) and screened for eligible articles. This review aims to synthesize evidence pertaining to primary care interventions on these two diseases, evaluated and tested in LMICs. Recent evidence on effectiveness of primary care interventions has attracted renewed calls for their implementation. Hypertension (HTN) and diabetes mellitus (DM) are highly prevalent in low- and middle-income countries (LMIC) and a leading cause of morbidity and mortality.
0 kommentar(er)
