The overall quality of evidence based on GRADE criteria was moderate for systolic blood pressure , but low for diastolic blood pressure .
INTERPRETATION Task-sharing interventions are effective in reducing blood pressure .
BACKGROUND Task sharing for the management of hypertension could be useful for understaffed and re source -poor health systems .
We assessed the effectiveness of task-sharing interventions in improving blood pressure control among adults in low-income and middle-income countries .
Cost-effectiveness of a diabetes group education program delivered by health promoters with a guiding style in underserved communities in Cape Town, South Africa.
OBJECTIVE This study aim ed to evaluate the cost-effectiveness of a group diabetes education program delivered by health promoters in community health centers in the Western Cape , South Africa . METHODS The effectiveness of the education program was derived from the outcomes of a pragmatic cluster r and omized controlled trial ( RCT ) . Incremental operational costs of the intervention , as implemented in the trial , were calculated . All these data were entered into a Markov micro-simulation model to simulate clinical outcomes and health costs that were expressed as an Incremental Cost Effectiveness Ratio ( ICER ) . RESULTS The only significant effect from the RCT at one year was a reduction in blood pressure ( systolic blood pressure -4.65 mmHg ( 95%CI:-9.18 to -0.12 ) and diastolic blood pressure -3.30 mmHg ( 95%CI:-5.35 to -1.26 ) ) . The ICER for the intervention , based on the assumption that the costs would recur every year and the effect could be maintained , was 1862 $ /QALY gained . CONCLUSION A structured group education program performed by mid-level trained healthcare workers at community health centers , for the management of Type II diabetes in the Western Cape , South Africa is therefore cost-effective . PRACTICE IMPLICATION S This cost-effectiveness analysis supports the more widespread implementation of this intervention in primary care within South Africa
The overall quality of evidence based on GRADE criteria was moderate for systolic blood pressure , but low for diastolic blood pressure .
INTERPRETATION Task-sharing interventions are effective in reducing blood pressure .
BACKGROUND Task sharing for the management of hypertension could be useful for understaffed and re source -poor health systems .
We assessed the effectiveness of task-sharing interventions in improving blood pressure control among adults in low-income and middle-income countries .