Evidence mapPaperPMID 41836051Full record

SynthesisGlobal heart2026

Cost-Effectiveness and Implementation Strategies for Hypertension Management Using Non-Physician Healthcare Workers in Low- and Middle-Income Countries: A Systematic Review.

Gabriel Lamkur Shedul, Olutobi Adekunle Sanuade, Emmanuel Iroboudu Okpetu, Molly Beestrum, Dike Bevis Ojji, Lisa R Hirschhorn, Mark D Huffman, Dustin D French

Abstract readSystematic Review
In one paragraph

Synthesis in Global heart, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Gabriel Lamkur ShedulDepartment of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, United States.ORCID 0000-0003-2295-908X
Olutobi Adekunle SanuadeDepartment of Population Health Sciences, Division of Health System Innovation and Research, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, United States.ORCID 0000-0003-4972-1098
Emmanuel Iroboudu OkpetuDepartment of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, United States.ORCID 0000-0001-9103-9899
Molly BeestrumGalter Health Sciences Library & Learning Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States.ORCID 0000-0001-6524-6464
Dike Bevis OjjiCardiovascular Research Unit, University of Abuja, Abuja, Nigeria.ORCID 0000-0002-2084-1988
Lisa R HirschhornDepartment of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, United States.ORCID 0000-0002-4355-7437
Mark D HuffmanCardiovascular Division and Global Health Center, Washington University in St. Louis, Saint Louis, United States.ORCID 0000-0001-7412-2519
Dustin D FrenchDepartment of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.ORCID 0000-0003-4064-3206

Funding

Cardiovascular Research Training In Nigeria (CeRTIN)D43TW011976 · NORTHWESTERN UNIVERSITY · 2025 to 2025
$247k
FIC NIH HHS D43 TW011976
6 · The paper itself

Abstract

Background: This review assessed the cost-effectiveness and implementation strategies of hypertension management by non-physician healthcare workers (NPHCWs) in low- and middle-income countries (LMICs). Methods: A systematic search (inception-May 2024) included adults ≥18 years managed by NPHCWs LMICs, following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Economic evaluations were assessed using Drummond's checklist and ROBINS-I. Results: Seven studies (2002-2022) conducted across eight countries enrolled 96-10,000 participants and included randomized, modeling, observational, and quasi-experimental designs. NPHCWs included pharmacists, community and village health workers, and nurses. Patients' mean age ranged 58-71 years, with 57-82% female. Outcomes assessed included cost per mmHg reduction ($INT 2.25 systolic, $INT 2.03 diastolic), per controlled patient ($INT 1.48), annual cost ($INT 0.22-232.31), cost per disability-adjusted life year (DALY) averted ($INT 411.39-4709.96), and per quality-adjusted life year (QALY) gained ($INT 1.04-13.30). Incremental cost-effectiveness ratio (ICERs) varied ($INT 0.41-14,373.97). Strategies included NPHCWs training and community engagement/counseling. Conclusion: Hypertension management by NPHCWs appears cost-effective in LMICs, though more studies are needed for generalizability.

Indexed as

Developing CountriesDisease ManagementHealth PersonnelHypertensionCommunity Health WorkersCost-Benefit AnalysisCost-Effectiveness AnalysisHumansResource-Limited SettingsTask Shiftingcost-effectivenesshypertensionlow-middle-income countriesnon-physician-healthcare workersstrategiestask-shifting

Identifiers

PMID41836051
PMCPMC12985814

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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 Socratic graph.