Effectiveness of interventions by nurse practitioners for prevention and control of noncommunicable diseases in low- and middle-income countries: A systematic review protocol

Introduction: Low- and middle-income countries (LMICs) face numerous challenges in the implementation of noncommunicable disease (NCD) prevention programs due to a shortage of health manpower. Task shifting to nurses is a viable and effective solution to address the health-care human resource crisis. The major advantage of involving nurses is that they are the largest, skilled, and already established workforce in any health-care institution. Despite the effectiveness of NCD interventions by nurse practitioners (NPs), there is a relative lack of evidence from LMICs which prevents the scale-up of the NPs model for better health outcomes. We, therefore, intend to assess the existing evidence on the effectiveness of interventions by NPs for the management of chronic NCDs in LMICs. Methods and Analysis: Electronic databases, i.e., PubMed, Excerpta Medica Database (EMBASE), CINAHL, Cochrane Central Register of Controlled Trials, and clinical registries of different LMICs in the English language shall be searched between 2004 and 2019 (last 15 years). Research designs to be included are randomized controlled trials, before-after studies, and Quasi-experimental studies. The primary outcome includes the change in behavioral risk factors, physiological risk factors, and clinical parameters. Subgroup and sensitivity analysis will be performed. Ethics and Dissemination: Ethical approval has been obtained from the institute ethics committee. Results will be disseminated through peer-reviewed scientific journals and presentation at national and international conferences. Study Design: Systematic review. PROSPERO registration number CRD42019118430