Team-based care interventions led by non-physician healthcare providers in Africa resulted in a mean systolic blood pressure reduction of 3.91 mm Hg (95% CI -5.68 to -2.15).
Meta-Analysis
Yes
Do team-based care interventions led by non-physician healthcare providers reduce systolic blood pressure in adults with hypertension in Africa?
Team-based care interventions led by non-physician healthcare providers may result in a small but significant reduction in systolic blood pressure among adults with hypertension in Africa.
Effect estimate: Mean reduction -3.91 mm Hg (95% CI -5.68 to -2.15)
OBJECTIVE: We evaluated the effectiveness of team-based care interventions in improving blood pressure (BP) outcomes among adults with hypertension in Africa. DESIGN: Systematic review and meta-analysis. DATA SOURCE: PubMed, CINAHL, EMBASE, Cochrane Library, HINARI and African Index Medicus databases were searched from inception to March 2023. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: We included randomised controlled trials (RCTs) and pre-post study designs published in English language focusing on (1) Adults diagnosed with hypertension, (2) Team-based care hypertension interventions led by non-physician healthcare providers (HCPs) and (3) Studies conducted in Africa. DATA EXTRACTION AND SYNTHESIS: We extracted study characteristics, the nature of team-based care interventions, team members involved and other reported secondary outcomes. Risk of bias was assessed using the Cochrane Risk of Bias tool for RCTs and the National Heart, Lung, and Blood Institute assessment tool for pre-post studies. Findings were summarised and presented narratively including data from pre-post studies. Meta-analysis was conducted using a random effects model for only RCT studies. Overall certainty of evidence was determined using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) tool for only the primary outcome (systolic BP). RESULTS: Of the 3375 records screened, 33 studies (16 RCTs and 17 pre-post studies) were included and 11 RCTs were in the meta-analysis. The overall mean effect of team-based care interventions on systolic BP reduction was -3.91 mm Hg (95% CI -5.68 to -2.15, I² = 0.0%). Systolic BP reduction in team-based care interventions involving community health workers was -4.43 mm Hg (95% CI -5.69 to -3.17, I² = 0.00%) and nurses -3.75 mm Hg (95% CI -10.62 to 3.12, I² = 42.0%). Based on the GRADE assessment, we judged the overall certainty of evidence low for systolic BP reduction suggesting that team-based care intervention may result in a small reduction in systolic BP. CONCLUSION: CRD42023398900.
Hinneh et al. (Mon,) conducted a meta-analysis in Hypertension. Team-based care interventions led by non-physician healthcare providers was evaluated on Systolic blood pressure reduction (Mean reduction -3.91 mm Hg, 95% CI -5.68 to -2.15). Team-based care interventions led by non-physician healthcare providers in Africa resulted in a mean systolic blood pressure reduction of 3.91 mm Hg (95% CI -5.68 to -2.15).