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 randomized controlled trials (RCTs), for the use of task-shifting strategies for cardiovascular disease (CVD) risk reduction in low- and middle-income countries (LMICs). Design: Systematic review of RCTs that utilized task-shifting strategy in management of CVD in LMICs. Data Sources: We searched the following databases for relevant RCTs: PubMed from 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 either prescribing of medications, treatment and/or medical testing), use of non-physician healthcare providers in management of CV risk factors and diseases (hypertension, diabetes, hyperlipidemia, stroke, coronary artery disease, or heart failure), and RCTs that were conducted in LMICs. We excluded studies that are not RCTs. Results: Of the 2771 articles identified, only three met 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 three months to 12 months; and the task-shifting strategies included provision of medication prescriptions by nurses, community health workers, and pharmacists; and telephone follow up post-hospital discharge. Both hypertension studies reported mean significant blood pressure reduction (2/1 mm Hg and 30/15 mm Hg); and the diabetes trial reported reduction in HbA1c 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 global CVD epidemic in LMICs are urgently needed.