Data from: Task shifting interventions for cardiovascular risk reduction in low-and middle-income countries: a systematic review of randomized controlled trials

Objective: To evaluate evidence from published randomised controlled
trials (RCTs) for the use of task-shifting strategies for cardiovascular
disease (CVD) risk reduction in low-income and middle-income countries
(LMICs). Design: Systematic review of RCTs that utilised a task-shifting
strategy in the management of CVD in LMICs. Data Sources: We searched the
following databases for relevant RCTs: PubMed from the 1940s, EMBASE from
1974, Global Health from 1910, Ovid Health Star from 1966, Web of
Knowledge from 1900, Scopus from 1823, CINAHL from 1937 and RCTs from
ClinicalTrials.gov. Eligibility criteria for selecting studies: We focused
on RCTs published in English, but without publication year. We included
RCTs in which the intervention used task shifting (non-physician
healthcare workers involved in prescribing of medications, treatment
and/or medical testing) and non-physician healthcare providers in the
management of CV risk factors and diseases (hypertension, diabetes,
hyperlipidaemia, stroke, coronary artery disease or heart failure), as
well as RCTs that were conducted in LMICs. We excluded studies that are
not RCTs. Results: Of the 2771 articles identified, only three met the
predefined criteria. All three trials were conducted in practice-based
settings among patients with hypertension (2 studies) and diabetes (1
study), with one study also incorporating home visits. The duration of the
studies ranged from 3 to 12 months, and the task-shifting strategies
included provision of medication prescriptions by nurses, community health
workers and pharmacists and telephone follow-up posthospital discharge.
Both hypertension studies reported a significant mean blood pressure
reduction (2/1 mm Hg and 30/15 mm Hg), and the diabetes trial reported a
reduction in the glycated haemoglobin levels of 1.87%. Conclusions: There
is a dearth of evidence on the implementation of task-shifting strategies
to reduce the burden of CVD in LMICs. Effective task-shifting
interventions targeted at reducing the global CVD epidemic in LMICs are
urgently needed.