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Task-shifting for cardiovascular risk factor management: lessons from the Global Alliance for Chronic Diseases
Task-shifting to non-physician health workers (NPHWs) has been an effective model for managing infectious diseases and improving maternal and child health. There is inadequate evidence to show the effectiveness of NPHWs to manage cardiovascular diseases (CVDs). In 2012, the Global Alliance for Chron...
Autores principales: | , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6231102/ https://www.ncbi.nlm.nih.gov/pubmed/30483414 http://dx.doi.org/10.1136/bmjgh-2018-001092 |
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author | Joshi, Rohina Thrift, Amanda G Smith, Carter Praveen, Devarsetty Vedanthan, Rajesh Gyamfi, Joyce Schwalm, Jon-David Limbani, Felix Rubinstein, Adolfo Parker, Gary Ogedegbe, Olugbenga Plange-Rhule, Jacob Riddell, Michaela A Thankappan, Kavumpurathu R Thorogood, Margaret Goudge, Jane Yeates, Karen E |
author_facet | Joshi, Rohina Thrift, Amanda G Smith, Carter Praveen, Devarsetty Vedanthan, Rajesh Gyamfi, Joyce Schwalm, Jon-David Limbani, Felix Rubinstein, Adolfo Parker, Gary Ogedegbe, Olugbenga Plange-Rhule, Jacob Riddell, Michaela A Thankappan, Kavumpurathu R Thorogood, Margaret Goudge, Jane Yeates, Karen E |
author_sort | Joshi, Rohina |
collection | PubMed |
description | Task-shifting to non-physician health workers (NPHWs) has been an effective model for managing infectious diseases and improving maternal and child health. There is inadequate evidence to show the effectiveness of NPHWs to manage cardiovascular diseases (CVDs). In 2012, the Global Alliance for Chronic Diseases funded eight studies which focused on task-shifting to NPHWs for the management of hypertension. We report the lessons learnt from the field. From each of the studies, we obtained information on the types of tasks shifted, the professional level from which the task was shifted, the training provided and the challenges faced. Additionally, we collected more granular data on ‘lessons learnt ’ throughout the implementation process and ‘design to implementation’ changes that emerged in each project. The tasks shifted to NPHWs included screening of individuals, referral to physicians for diagnosis and management, patient education for lifestyle improvement, follow-up and reminders for medication adherence and appointments. In four studies, tasks were shifted from physicians to NPHWs and in four studies tasks were shared between two different levels of NPHWs. Training programmes ranged between 3 and 7 days with regular refresher training. Two studies used clinical decision support tools and mobile health components. Challenges faced included system level barriers such as inability to prescribe medicines, varying skill sets of NPHWs, high workload and staff turnover. With the acute shortage of the health workforce in low-income and middle-income countries (LMICs), achieving better health outcomes for the prevention and control of CVD is a major challenge. Task-shifting or sharing provides a practical model for the management of CVD in LMICs. |
format | Online Article Text |
id | pubmed-6231102 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-62311022018-11-27 Task-shifting for cardiovascular risk factor management: lessons from the Global Alliance for Chronic Diseases Joshi, Rohina Thrift, Amanda G Smith, Carter Praveen, Devarsetty Vedanthan, Rajesh Gyamfi, Joyce Schwalm, Jon-David Limbani, Felix Rubinstein, Adolfo Parker, Gary Ogedegbe, Olugbenga Plange-Rhule, Jacob Riddell, Michaela A Thankappan, Kavumpurathu R Thorogood, Margaret Goudge, Jane Yeates, Karen E BMJ Glob Health Analysis Task-shifting to non-physician health workers (NPHWs) has been an effective model for managing infectious diseases and improving maternal and child health. There is inadequate evidence to show the effectiveness of NPHWs to manage cardiovascular diseases (CVDs). In 2012, the Global Alliance for Chronic Diseases funded eight studies which focused on task-shifting to NPHWs for the management of hypertension. We report the lessons learnt from the field. From each of the studies, we obtained information on the types of tasks shifted, the professional level from which the task was shifted, the training provided and the challenges faced. Additionally, we collected more granular data on ‘lessons learnt ’ throughout the implementation process and ‘design to implementation’ changes that emerged in each project. The tasks shifted to NPHWs included screening of individuals, referral to physicians for diagnosis and management, patient education for lifestyle improvement, follow-up and reminders for medication adherence and appointments. In four studies, tasks were shifted from physicians to NPHWs and in four studies tasks were shared between two different levels of NPHWs. Training programmes ranged between 3 and 7 days with regular refresher training. Two studies used clinical decision support tools and mobile health components. Challenges faced included system level barriers such as inability to prescribe medicines, varying skill sets of NPHWs, high workload and staff turnover. With the acute shortage of the health workforce in low-income and middle-income countries (LMICs), achieving better health outcomes for the prevention and control of CVD is a major challenge. Task-shifting or sharing provides a practical model for the management of CVD in LMICs. BMJ Publishing Group 2018-11-08 /pmc/articles/PMC6231102/ /pubmed/30483414 http://dx.doi.org/10.1136/bmjgh-2018-001092 Text en © Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ |
spellingShingle | Analysis Joshi, Rohina Thrift, Amanda G Smith, Carter Praveen, Devarsetty Vedanthan, Rajesh Gyamfi, Joyce Schwalm, Jon-David Limbani, Felix Rubinstein, Adolfo Parker, Gary Ogedegbe, Olugbenga Plange-Rhule, Jacob Riddell, Michaela A Thankappan, Kavumpurathu R Thorogood, Margaret Goudge, Jane Yeates, Karen E Task-shifting for cardiovascular risk factor management: lessons from the Global Alliance for Chronic Diseases |
title | Task-shifting for cardiovascular risk factor management: lessons from the Global Alliance for Chronic Diseases |
title_full | Task-shifting for cardiovascular risk factor management: lessons from the Global Alliance for Chronic Diseases |
title_fullStr | Task-shifting for cardiovascular risk factor management: lessons from the Global Alliance for Chronic Diseases |
title_full_unstemmed | Task-shifting for cardiovascular risk factor management: lessons from the Global Alliance for Chronic Diseases |
title_short | Task-shifting for cardiovascular risk factor management: lessons from the Global Alliance for Chronic Diseases |
title_sort | task-shifting for cardiovascular risk factor management: lessons from the global alliance for chronic diseases |
topic | Analysis |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6231102/ https://www.ncbi.nlm.nih.gov/pubmed/30483414 http://dx.doi.org/10.1136/bmjgh-2018-001092 |
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