EFFECT OF STRUCTURED SELF-MANAGEMENT EDUCATION ON CARDIOMETABOLIC DISEASE OUTCOMES IN SUBSAHARAN AFRICA: A SYSTEMATIC REVIEW.

Background: Sub-Saharan Africa faces a rising burden of non-communicable diseases, particularly among young adults. Structured self-management education is essential for managing chronic conditions, especially in low-income settings where a significant portion of the population with noncommunicable diseases resides.

Objective: To describe the effect of structured self-management education interventions on cardiometabolic disease outcomes in Sub-Saharan Africa.

Methods: A systematic review of controlled trials that assessed the effect of structured self-management education interventions on cardiometabolic outcomes such as HbA1c, blood pressure, and quality of life was conducted. We searched across PubMed, CINAHL, and Cochrane Library databases. Data retrieval, appraisal, and extraction were done with confidence and involved key study characteristics. The risk of bias was assessed using the Cochrane Risk-of-Bias tool. The review was registered on PROSPERO CRD42024539490.

Results: In total 1821 studies were identified. Of these, 19 studies involving 6344 participants from eight sub-Saharan countries were included. The review found that in six out of 14 studies, structured self-management education intervention significantly improved glycaemic control in patients with type 2 diabetes. However, evidence regarding blood pressure control was limited, with only five studies reporting relevant outcomes, two of which showed statistically significant improvements. Overall, 68% (n=13) of the studies had either high risk or some risk of bias.

Conclusions: The existing evidence on the effect of structured self-management education interventions on cardiometabolic disease outcomes in Sub-Saharan Africa is limited and checkered. Larger controlled trials are urgently needed to guide policy, and clinical practice and hopefully reverse the disturbing epidemiological trends in SubSaharan Africa.