SynthesisFamily medicine and community health2025
Global evidence on the effectiveness of task-shifting and task-sharing strategies for managing individuals with multimorbidity: systematic review and meta-analysis.
Synthesis in Family medicine and community health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
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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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Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Quantifying the evidence and burden of smoking behaviour on tuberculosis incidence among adult population: a systematic review and meta-analysis.Journal of global health · 2026Pooled it
- Distinguishing task shifting from task sharing through the delegating provider's presence or absence: proposed operational definitions.Journal of global health · 2026Article
- Care facilitation by Accredited Social Health Activists (ASHAs) to improve outcomes of persons with psychiatric disorders: Results from a randomized controlled trial in South India.Indian journal of psychiatry · 2026Article
- How direct access to physiotherapy reshapes GP gatekeeping for musculoskeletal care in primary care: an exploratory organisational typology across health systems.Family medicine and community health · 2026Article
Corrections and comments
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionTask-shifting and task-sharing strategies show promise for managing chronic diseases especially in low-income and middle-income countries (LMICs), though their effectiveness in multimorbidity management remains unclear. This study synthesised evidence on task-shifting and task-sharing strategies globally and assessed the impact on core health outcomes in multimorbidity management.
methodsWe conducted a systematic review and meta-analysis of global studies evaluating task-shifting and sharing interventions for individuals with multimorbidity. Six databases, including PubMed, Embase, Web of Science, Ovid (Medline), CINAHL and Cochrane Library, were searched for studies reporting the core outcomes of multimorbidity management in quality of life, mortality, hospitalisation, emergency department visits and symptoms of depression and anxiety. Random-effects models were used to calculate pooled effect sizes with heterogeneity assessed through subgroup and meta-regression analyses.
resultsFrom 8471 records, 36 studies from 14 countries were included, with only 5 conducted in LMICs. Twenty-one studies, encompassing 20 989 participants, were eligible for meta-analysis. More than half of the studies involved nurses as delegates, with some sharing the tasks with health professionals and about 10% of studies involved non-health professionals, including community healthcare workers as delegates to share the responsibility in caring for individuals with multimorbidity. Most studies were multicomponent, with 16.7% addressing all guideline-recommended aspects of multimorbidity management. By pooling the findings, task-shifting and task-sharing interventions were associated with a 27% reduction in mortality (OR: 0.73, 95% CI: 0.55 to 0.97, I²=0%), a modest improvement in quality of life (standardised mean difference (SMD): 0.1, 95% CI: 0.03 to 0.17, I²=47%) and reduced symptoms of depression (SMD: 0.27, 95% CI: -0.52 to -0.02, I²=90%), but showed no significant effect on hospitalisation, emergency visits or anxiety-related symptoms.
conclusionsSome evidence, although limited in existing research, indicates the great potential of task-shifting and task-sharing strategies in supporting management of multimorbidity. Further research is needed to optimise and adopt these interventions, particularly in LMICs where evidence remains scarce. PROSPERO REGISTRATION NUMBER: CRD42024526845.
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