Expanding access to NCD services via community retail pharmacies in LMICs: a systematic review of the literature
Author(s)
Gentilini, Arianna
Kasonde, Lombe
Babar, Zaheer-Ud-Din
Type
Journal Article
Abstract
Background
Non-communicable diseases (NCDs) pose a significant global health challenge. In LMICs, NCDs are an incresing driver of premature deaths and have substantial economic impacts, particularly on working-age adults. The World Health Organization has identified four priority NCDs – cardiovascular diseases, diabetes, asthma/chronic obstructive pulmonary disease, and cancer – which are included in its Package of Essential Non-Communicable Disease Interventions for low-resource primary care settings. However, a shortage of healthcare professionals further compounds the problem. Pharmacists, who could play a pivotal role in NCD care, remain underutilised.
Methods
We conducted a systematic literature review to identify studies on the role of community pharmacies and pharmacists in delivering NCD services in low- and middle-income settings and assessed their risk of bias. Searches were performed in PubMed, MEDLINE via Ovid, and CINAHL from 1990 to 2022, including English, French, or Spanish publications.
Results
Out of 1,284 articles, 23 met inclusion criteria, predominantly focusing on diabetes (65%), followed by cardiovascular diseases (22%), cancer (9%), and asthma (4%). Most studies were conducted in Asia (52%), followed by South America (22%) and Africa (13%). Significant improvements were observed in glycaemic control and medication adherence for diabetes, and in blood pressure management and adherence for hypertension. Positive outcomes were also seen in health behaviours for breast cancer, asthma, and cardiovascular disease risk management. Interventions were cost-effective for managing diabetes and hypertension in elderly patients. However, accessibility challenges were noted in vaccination programmes, and concerns about bias were identified, particularly in observational studies.
Conclusions
Expanding NCD services through community pharmacies in low and middle-income countries can significantly improve health outcomes. Pharmacists can enhance education, screening, and management for NCDs, leading to better disease control and patient satisfaction. Addressing resource constraints, legal barriers, and disease focus disparities is essential. Adequate training, financial incentives, and collaboration among stakeholders are crucial for integrating pharmacists into NCD care frameworks.
Non-communicable diseases (NCDs) pose a significant global health challenge. In LMICs, NCDs are an incresing driver of premature deaths and have substantial economic impacts, particularly on working-age adults. The World Health Organization has identified four priority NCDs – cardiovascular diseases, diabetes, asthma/chronic obstructive pulmonary disease, and cancer – which are included in its Package of Essential Non-Communicable Disease Interventions for low-resource primary care settings. However, a shortage of healthcare professionals further compounds the problem. Pharmacists, who could play a pivotal role in NCD care, remain underutilised.
Methods
We conducted a systematic literature review to identify studies on the role of community pharmacies and pharmacists in delivering NCD services in low- and middle-income settings and assessed their risk of bias. Searches were performed in PubMed, MEDLINE via Ovid, and CINAHL from 1990 to 2022, including English, French, or Spanish publications.
Results
Out of 1,284 articles, 23 met inclusion criteria, predominantly focusing on diabetes (65%), followed by cardiovascular diseases (22%), cancer (9%), and asthma (4%). Most studies were conducted in Asia (52%), followed by South America (22%) and Africa (13%). Significant improvements were observed in glycaemic control and medication adherence for diabetes, and in blood pressure management and adherence for hypertension. Positive outcomes were also seen in health behaviours for breast cancer, asthma, and cardiovascular disease risk management. Interventions were cost-effective for managing diabetes and hypertension in elderly patients. However, accessibility challenges were noted in vaccination programmes, and concerns about bias were identified, particularly in observational studies.
Conclusions
Expanding NCD services through community pharmacies in low and middle-income countries can significantly improve health outcomes. Pharmacists can enhance education, screening, and management for NCDs, leading to better disease control and patient satisfaction. Addressing resource constraints, legal barriers, and disease focus disparities is essential. Adequate training, financial incentives, and collaboration among stakeholders are crucial for integrating pharmacists into NCD care frameworks.
Date Issued
2025-12-01
Date Acceptance
2025-01-30
Citation
Journal of Pharmaceutical Policy and Practice, 2025, 18 (1)
ISSN
2052-3211
Publisher
Taylor & Francis Group
Journal / Book Title
Journal of Pharmaceutical Policy and Practice
Volume
18
Issue
1
Copyright Statement
© 2025 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent.
License URL
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/39968320
PII: 2462450
Subjects
ADHERENCE
community pharmacies
Health Care Sciences & Services
Health Policy & Services
INTERVENTIONS
Life Sciences & Biomedicine
low and middle-income countries
Non-communicable diseases
package of essential non-communicable disease interventions
PHARMACEUTICAL CARE PROGRAM
Pharmacology & Pharmacy
PRIMARY-HEALTH-CARE
Science & Technology
TYPE-2 DIABETES PATIENTS
Publication Status
Published
Coverage Spatial
England
Article Number
2462450
Date Publish Online
2025-02-17