Shifting selected antiretroviral therapy (ART) tasks from specialised healthcare workers to those with shorter or less formal training has been implemented in resource-limited settings to alleviate critical shortages of human resources for health. However, the specifics of shifting ART dispensing from pharmacy to non-pharmacy personnel have not been addressed in a systematic review, although this can potentially increase access to ART. We will assess the effects of shifting dispensing and distribution of ART and adherence assessment from pharmacy to non-pharmacy personnel in low and middle-income countries.
Methods and analysis
We will search PubMed, CENTRAL, EMBASE, WHO Global Health Library and relevant grey literature for eligible controlled trials. Two authors will screen the search output, select eligible studies, assess risk of bias and extract data from included studies, resolving discrepancies by discussion and consensus. We will perform meta-analysis using both fixed and random effects models, investigate clinical and statistical heterogeneity, and assess our confidence in the overall evidence using standard Cochrane methods, including GRADE.
Ethics and dissemination
Only secondary data will be included in this review and ethics approval is not required. We will disseminate the review findings in various scientific fora, including peer-reviewed journals. The findings may help to inform policy makers in defining the scope of work of healthcare workers, and global recommendations for shifting the dispensing and distribution of ART from pharmacy to non-pharmacy personnel.
Citation: Nyanyiwe M Mbeye, Tamara Kredo, Charles S Wiysonge The effects of shifting tasks from pharmacy to non-pharmacy personnel for providing antiretroviral therapy to people living with HIV: a systematic review protocol
BMJ Open 2016;6:e008195 doi:10.1136/bmjopen-2015-008195
Received: 15 March 2015 Revised: 16 November 2015 Accepted: 17 November 2015 Published: 11 March 2016
Copyright: This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/
The authors acknowledge the Editor and the referees for critical and constructive comments on earlier versions of this manuscript. The authors would also like to acknowledge the various contributions of Eyerusalem Negussie.
NMM led the development of the protocol, wrote the first draft, coordinated and integrated comments from co-authors and approved the final version for publication. TK and CSW conceived the study, critically revised successive drafts of the manuscript, and approved the final version for publication. CSW is the guarantor of the manuscript.
Funding for preparing this review was provided by the Department of HIV/AIDS at the WHO Headquarters in Geneva, Switzerland. The authors would like to thank Hacsi Horvath (Global Health Sciences, University of California, San Francisco, USA) for his assistance in developing the search strategy for electronic databases. Neither the authors’ institutions nor the funder played a role in preparing the manuscript and the views expressed therein are solely those of the authors.
Competing Interests None declared.