SynthesisBMJ open2023
Effectiveness of integrated chronic care models for cardiometabolic multimorbidity in sub-Saharan Africa: a systematic review and meta-analysis.
Synthesis in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed.
- Estimating investment costs to improve hypertension care in Lagos, Nigeria.Communications medicine · 2026Article
- Lifestyle Medicine Perspectives from Nursing in Community Care Setting: A Narrative Review.Nursing reports (Pavia, Italy) · 2026Review
- Evaluation of a training intervention for primary healthcare workers to improve management of diabetes and hypertension in Kisumu County, Kenya: a mixed-methods study.BMC health services research · 2026Article
- Transforming hypertension management with digital technology: a retrospective cohort study in four sub-Saharan African countries.BMJ public health · 2026Article
- Primary health care interventions targeting diabetes, hypertension or dyslipidemia in Malaysia: A scoping review.PloS one · 2026Article
- Review
- Community-based management strategies for adults with multimorbidity: a systematic review of clinical and patient-centred outcomes.BMJ public health · 2026Article
- Development of a collaborative chronic care model for management of cardiometabolic disease in low- and middle-income countries.PloS one · 2026Article
- An ICF-based interdisciplinary case management improves functioning, participation, and well-being for people with disabilities in community rehabilitation: a protocol for a randomised controlled trial.Frontiers in rehabilitation sciences · 2026Article
- Disease control and its correlates among hypertensive, diabetic, and asthmatic patients enrolled in secondary-level Integrated Chronic Care Clinics in Neno District, rural Malawi.PLOS global public health · 2026Article
- Rethinking the Diabetes-Cardiovascular Disease Continuum: Toward Integrated Care.Journal of clinical medicine · 2025Article
- Implementation of hospital-initiated complex interventions for adult people with multiple long-term conditions: a scoping review.BMC health services research · 2025Article
- Models of care and associated targeted implementation strategies for cancer survivorship support in Europe: a scoping review protocol.BMJ open · 2025Article
- Rethinking chronic care: how blended patient-centered care delivery and innovative financing models can contribute to achieving universal health coverage-a case study of an integrated approach in Kenya.Oxford open digital health · 2025Article
- Article
- Stakeholder perspectives on the barriers and facilitators to integrating cardiovascular disease and diabetes management at primary care in Kenya.PLOS global public health · 2025Article
- Article
- Primary healthcare nurses' experiences in managing chronic diseases during COVID-19 in the North West province.African journal of primary health care & family medicine · 2024Article
- Article
- Chronic Conditions and Multimorbidity Among Middle-Aged and Elderly Peri-Urban Dwellers in Dar es Salaam, Tanzania.International journal of public health · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
objectivesThis review aimed at identifying the elements of integrated care models for cardiometabolic multimorbidity in sub-Saharan Africa (SSA) and their effects on clinical or mental health outcomes including systolic blood pressure (SBP), blood sugar, depression scores and other patient-reported outcomes such as quality of life and medication adherence.
designSystematic review and meta-analysis using the Grading of Recommendation, Assessment, Development and Evaluation (GRADE) approach. DATA SOURCES: We systematically searched PubMed, Embase, Scopus, Web of Science, Global Health CINAHL, African Journals Online, Informit, PsycINFO, ClinicalTrials.gov, Pan African Clinical Trials Registry and grey literature from OpenSIGLE for studies published between 1999 and 2022. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: We included randomised controlled trial studies featuring integrated care models with two or more elements of Wagner's chronic care model. DATA EXTRACTION AND SYNTHESIS: Two independent reviewers used standardised methods to search and screen included studies. Publication bias was assessed using the Doi plot and Luis Furuya Kanamori Index. Meta-analysis was conducted using random effects models.
resultsIn all, we included 10 randomised controlled trials from 11 publications with 4864 participants from six SSA countries (South Africa, Kenya, Nigeria, Eswatini, Ghana and Uganda). The overall quality of evidence based on GRADE criteria was moderate. A random-effects meta-analysis of six studies involving 1754 participants shows that integrated compared with standard care conferred a moderately lower mean SBP (mean difference=-4.85 mm Hg, 95% CI -7.37 to -2.34) for people with cardiometabolic multimorbidity; Hedges' g effect size (g=-0.25, (-0.39 to -0.11). However, integrated care compared with usual care showed mixed results for glycated haemoglobin, depression, medication adherence and quality of life.
conclusionIntegrated care improved SBP among patients living with cardiometabolic multimorbidity in SSA. More studies on integrated care are required to improve the evidence pool on chronic care models for multimorbidity in SSA. These include implementation studies and cost-effectiveness studies. PROSPERO REGISTRATION NUMBER: CRD42020187756.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.