Effectiveness of community-based, peer-led approaches compared with usual care in controlling hypertension in low- and middle-income countries: a systematic review protocol

The objective of this systematic review will be to synthesize the evidence on the effectiveness of community-based, peer-led interventions compared with usual care in controlling hypertension in low- and middle-income countries (LMICs). Hypertension is a critical global health issue, particularly in LMICs, where it contributes to a significant health and economic burden. Effective management strategies, including community-based, peer-led interventions, show promise; however, their effectiveness in these settings remains uncertain. The review will focus on community-based, peer-led interventions for adults with hypertension in LMICs. It will include peer-led interventions such as health education and behavioral change programs, and compare them with usual care. The review will assess outcomes such as changes in systolic and diastolic blood pressure and hypertension control rates. Both experimental and quasi-experimental studies published in English from data inception until April 2025 will be included. The review will follow the JBI methodology for systematic reviews of effectiveness. An initial comprehensive search strategy will be developed in MEDLINE (Ovid). This strategy will then be adapted for additional databases, including CINAHL (EBSCOhost), Scopus, Cochrane CENTRAL, ProQuest Dissertations and Theses Global, and Google Scholar. Two reviewers will independently screen records against the eligibility criteria, conduct critical appraisal, and extract data, focusing on participants, methods, interventions, and outcomes. Data synthesis will include statistical meta-analysis, while the certainty of findings will be assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. A will present key information and the quality of evidence. The results will be presented narratively, summarizing weighted mean differences in post-intervention blood pressure (mmHg) and 95% CIs. Meta-analyses will be conducted where appropriate, with assessments of heterogeneity and subgroup analyses. PROSPERO CRD42024575369.