ArticleBMJ global health2018
The Practical Approach to Care Kit (PACK) guide: developing a clinical decision support tool to simplify, standardise and strengthen primary healthcare delivery.
Article in BMJ global health, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 59 papers, 1 of them a synthesis that pooled it.
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Who cites it
59 citing papers in PubMed, 1 synthesis or guideline pooled it.
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- Primary health care approach to rheumatic heart disease management.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2026Review
- From face-to-face to e-learning: transitioning to new training models to strengthen the health system by supporting primary healthcare workers in low- and middle-income countries.BMJ global health · 2026Article
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- Addressing health information inequities: making evidence-based clinical content more accessible in low- and middle-income primary care.BMJ global health · 2025Article
- Managing mental health disorders: Experiences of primary care providers in rural South Africa.African journal of primary health care & family medicine · 2025Observational
- Development and implementation of a digital clinical decision support system to increase the quality of primary healthcare delivery in a refugee setting in Chad.BMC primary care · 2025Article
- Nursing Protocols: Macro and Micropolitics in Primary Health Care Management.Revista brasileira de enfermagem · 2025Article
- Barriers and facilitators of primary care management of type II diabetes mellitus in the West African sub-region: A scoping review.PLOS global public health · 2025Article
- Revisiting health systems to integrate perinatal mental health into maternal and child health services: perspectives from research, policy and implementation.BMJ global health · 2024Article
- Supporting a rapid primary care response to emergent communicable disease threats with PACK (Practical Approach to Care Kit) in Florianópolis, Brazil.BMJ global health · 2024Article
- Clinically sound and person centred: streamlining clinical decision support guidance for multiple long-term condition care.BMJ global health · 2024Article
Corrections and comments
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
For the primary health worker in a low/middle-income country (LMIC) setting, delivering quality primary care is challenging. This is often complicated by clinical guidance that is out of date, inconsistent and informed by evidence from high-income countries that ignores LMIC resource constraints and burden of disease. The Knowledge Translation Unit (KTU) of the University of Cape Town Lung Institute has developed, implemented and evaluated a health systems intervention in South Africa, and localised it to Botswana, Nigeria, Ethiopia and Brazil, that simplifies and standardises the care delivered by primary health workers while strengthening the system in which they work. At the core of this intervention, called Practical Approach to Care Kit (PACK), is a clinical decision support tool, the PACK guide. This paper describes the development of the guide over an 18-year period and explains the design features that have addressed what the patient, the clinician and the health system need from clinical guidance, and have made it, in the words of a South African primary care nurse, 'A tool for every day for every patient'. It describes the lessons learnt during the development process that the KTU now applies to further development, maintenance and in-country localisation of the guide: develop clinical decision support in context first, involve local stakeholders in all stages, leverage others' evidence databases to remain up to date and ensure content development, updating and localisation articulate with implementation.
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