Delivery of health care for cardiovascular and metabolic diseases among people living with HIV/AIDS in African countries: a systematic review protocol

dc.contributor.authorWatkins, David A
dc.contributor.authorTulloch, Nathaniel L
dc.contributor.authorAnderson, Molly E
dc.contributor.authorBarnhart, Scott
dc.contributor.authorSteyn, Krisela
dc.contributor.authorLevitt, Naomi S
dc.date.accessioned2016-05-23T07:50:46Z
dc.date.available2016-05-23T07:50:46Z
dc.date.issued2016
dc.date.updated2016-05-19T09:27:05Z
dc.description.abstractBackground: People living with HIV (PLHIV) in African countries are living longer due to the rollout of antiretroviral drug therapy programs, but they are at increasing risk of non-communicable diseases (NCDs). However, there remain many gaps in detecting and treating NCDs in African health systems, and little is known about how NCDs are being managed among PLHIV. Developing integrated chronic care models that effectively prevent and treat NCDs among PLHIV requires an understanding of the current patterns of care delivery and the major barriers and facilitators to health care. We present a systematic review protocol to synthesize studies of healthcare delivery for an important subset of NCDs, cardiovascular and metabolic diseases (CMDs), among African PLHIV. Methods/design: We plan to search electronic databases and reference lists of relevant studies published in African settings from January 2003 to the present. Studies will be considered if they address one or both of our major objectives and focus on health care for one or more of six interrelated CMDs (ischemic heart disease, stroke, heart failure, hypertension, diabetes, and hyperlipidemia) in PLHIV. Our first objective will be to estimate proportions of CMD patients along the “cascade of care”—i.e., screened, diagnosed, aware of the diagnosis, initiated on treatment, adherent to treatment, and with controlled disease. Our second objective will be to identify unique barriers and facilitators to health care faced by PLHIV in African countries. For studies deemed eligible for inclusion, we will assess study quality and risk of bias using previously published criteria. We will extract study data using standardized instruments. We will meta-analyze quantitative data at each level of the cascade of care for each CMD (first objective). We will use meta-synthesis techniques to understand and integrate qualitative data on health-related behaviors (second objective). Discussion: CMDs and other NCDs are becoming major health concerns for African PLHIV. The results of our review will inform the development of research into chronic care models that integrate care for HIV/AIDS and CMDs among PLHIV. Our findings will be highly relevant to health policymakers, administrators, and practitioners in African settings.en_ZA
dc.identifier.apacitationWatkins, D. A., Tulloch, N. L., Anderson, M. E., Barnhart, S., Steyn, K., & Levitt, N. S. (2016). Delivery of health care for cardiovascular and metabolic diseases among people living with HIV/AIDS in African countries: a systematic review protocol. <i>Systematic Reviews</i>, http://hdl.handle.net/11427/19769en_ZA
dc.identifier.chicagocitationWatkins, David A, Nathaniel L Tulloch, Molly E Anderson, Scott Barnhart, Krisela Steyn, and Naomi S Levitt "Delivery of health care for cardiovascular and metabolic diseases among people living with HIV/AIDS in African countries: a systematic review protocol." <i>Systematic Reviews</i> (2016) http://hdl.handle.net/11427/19769en_ZA
dc.identifier.citationWatkins, D. A., Tulloch, N. L., Anderson, M. E., Barnhart, S., Steyn, K., & Levitt, N. S. (2016). Delivery of health care for cardiovascular and metabolic diseases among people living with HIV/AIDS in African countries: a systematic review protocol. Systematic Reviews, 5(1), 1.en_ZA
dc.identifier.issn2046-4053en_ZA
dc.identifier.ris TY - Journal Article AU - Watkins, David A AU - Tulloch, Nathaniel L AU - Anderson, Molly E AU - Barnhart, Scott AU - Steyn, Krisela AU - Levitt, Naomi S AB - Background: People living with HIV (PLHIV) in African countries are living longer due to the rollout of antiretroviral drug therapy programs, but they are at increasing risk of non-communicable diseases (NCDs). However, there remain many gaps in detecting and treating NCDs in African health systems, and little is known about how NCDs are being managed among PLHIV. Developing integrated chronic care models that effectively prevent and treat NCDs among PLHIV requires an understanding of the current patterns of care delivery and the major barriers and facilitators to health care. We present a systematic review protocol to synthesize studies of healthcare delivery for an important subset of NCDs, cardiovascular and metabolic diseases (CMDs), among African PLHIV. Methods/design: We plan to search electronic databases and reference lists of relevant studies published in African settings from January 2003 to the present. Studies will be considered if they address one or both of our major objectives and focus on health care for one or more of six interrelated CMDs (ischemic heart disease, stroke, heart failure, hypertension, diabetes, and hyperlipidemia) in PLHIV. Our first objective will be to estimate proportions of CMD patients along the “cascade of care”—i.e., screened, diagnosed, aware of the diagnosis, initiated on treatment, adherent to treatment, and with controlled disease. Our second objective will be to identify unique barriers and facilitators to health care faced by PLHIV in African countries. For studies deemed eligible for inclusion, we will assess study quality and risk of bias using previously published criteria. We will extract study data using standardized instruments. We will meta-analyze quantitative data at each level of the cascade of care for each CMD (first objective). We will use meta-synthesis techniques to understand and integrate qualitative data on health-related behaviors (second objective). Discussion: CMDs and other NCDs are becoming major health concerns for African PLHIV. The results of our review will inform the development of research into chronic care models that integrate care for HIV/AIDS and CMDs among PLHIV. Our findings will be highly relevant to health policymakers, administrators, and practitioners in African settings. DA - 2016 DB - OpenUCT DO - 10.1186/s13643-016-0241-5 DP - University of Cape Town J1 - Systematic Reviews KW - HIV/AIDS KW - Non-communicable diseases KW - Cardiovascular disease KW - Diabetes KW - Delivery of health care KW - Access to health care KW - Screening KW - Diagnosis KW - Medication adherence KW - Africa LK - https://open.uct.ac.za PB - University of Cape Town PY - 2016 SM - 2046-4053 T1 - Delivery of health care for cardiovascular and metabolic diseases among people living with HIV/AIDS in African countries: a systematic review protocol TI - Delivery of health care for cardiovascular and metabolic diseases among people living with HIV/AIDS in African countries: a systematic review protocol UR - http://hdl.handle.net/11427/19769 ER - en_ZA
dc.identifier.urihttp://dx.doi.org/10.1186/s13643-016-0241-5
dc.identifier.urihttp://hdl.handle.net/11427/19769
dc.identifier.vancouvercitationWatkins DA, Tulloch NL, Anderson ME, Barnhart S, Steyn K, Levitt NS. Delivery of health care for cardiovascular and metabolic diseases among people living with HIV/AIDS in African countries: a systematic review protocol. Systematic Reviews. 2016; http://hdl.handle.net/11427/19769.en_ZA
dc.languageengen_ZA
dc.language.rfc3066en
dc.publisherBioMed Centralen_ZA
dc.publisher.departmentDepartment of Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsCreative Commons Attribution 4.0 International (CC BY 4.0)*
dc.rights.holderWatkins et al.
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_ZA
dc.sourceSystematic Reviewsen_ZA
dc.source.urihttp://systematicreviewsjournal.biomedcentral.com/
dc.subjectHIV/AIDS
dc.subjectNon-communicable diseases
dc.subjectCardiovascular disease
dc.subjectDiabetes
dc.subjectDelivery of health care
dc.subjectAccess to health care
dc.subjectScreening
dc.subjectDiagnosis
dc.subjectMedication adherence
dc.subjectAfrica
dc.titleDelivery of health care for cardiovascular and metabolic diseases among people living with HIV/AIDS in African countries: a systematic review protocolen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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