title: Effectiveness of community-based peer-led diabetes self-management programmes (COMP-DSMP) for improving clinical outcomes and quality of life of adults with diabetes in primary care settings in low and middle-income countries (LMIC): a systematic review and meta-analysis.
abstract: BACKGROUND
  Globally, an estimated 380 million people live with diabetes today--80% in low-income and middle-income countries. The Middle East, Western Pacific, Sub-Saharan Africa and South-East Asia remain the most affected regions where economic development has transformed lifestyles, people live longer and there is an increase in the adult population. Although peer support has been used in different conditions with varied results, yet there is limited evidence to date supporting its effectiveness, particularly for individuals with diabetes. In this review, we will focus on community-based peer-led diabetes self-management programmes (COMP-DSMP) and examine the implementation strategies and diabetes-related health outcomes associated with them in LMIC primary healthcare settings.
  
  
  METHODS
  In accordance with reporting equity-focused systematic reviews PRISMA-P (preferred reporting items for systematic review and meta-analysis protocols 2015 checklist) guidelines, a systematic review with meta-analysis of randomised controlled trials (RCTs), non-randomised controlled trials, quasi-randomised controlled trials (CCTs) that involve contact with an individual or group of peers (paid or voluntary). Electronic searches will be performed in The Cochrane Library, MEDLINE, PubMed, SCOUPS, CINAHL and PsycINFO Database for the period January up to July 2000 along with manual searches in the reference lists of relevant papers. The analyses will be performed based on baseline data from RCTs, CCTs and preintervention and postintervention means or proportions will be reported for both intervention and control groups, and the absolute change from baseline will be calculated, together with 95% CIs. For dichotomous outcomes, the relative risk of the outcome will be presented compared to the control group. The risk difference will be calculated, which is the absolute difference in the proportions in each treatment group.
  
  
  BACKGROUND
  Ethics is not required for this study, given that this is a protocol for a systematic review, which utilises published data. The findings of this study will be widely disseminated through peer-reviewed publications and conference presentations.
  
  
  BACKGROUND
  PROSPERO (2014:CRD42014007531).
authors.affiliation: Department of Medicine, Faculty of Health Science, University of Cape Town, Chronic Disease Initiative for Africa, Cape town, Western Cape, South Africa.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Werfalli
authors.affiliation: Department of Medicine, Faculty of Health Science, University of Cape Town, Cape Town, Western Cape, South Africa.
authors.forename: Peter
authors.initials: P
authors.lastname: Raubenheimer
authors.affiliation: Department of Medicine, Faculty of Health Science, University of Cape Town, Cape Town, Western Cape, South Africa Department of Medicine, University of Cape Town, Cape Town, Western Cape, South Africa.
authors.forename: Mark
authors.initials: M
authors.lastname: Engel
authors.affiliation: Chronic Diseases of Lifestyle Research Unit, Durban, Durban, South Africa.
authors.forename: Nasheeta
authors.initials: N
authors.lastname: Peer
authors.affiliation: Department of Medicine, University of Cape Town, Cape Town, Western Cape, South Africa Department of Geriatric Medicine, Faculty of Health Science, University of Cape Town, South Africa, Cape Town, Western Cape, South Africa.
authors.forename: Sebastiana
authors.initials: S
authors.lastname: Kalula
authors.affiliation: South African Medical Research Council, Cape Town, South Africa.
authors.forename: Andre P
authors.initials: AP
authors.lastname: Kengne
authors.affiliation: Department of Medicine, Faculty of Health Science, University of Cape Town, Chronic Disease Initiative for Africa, Cape town, Western Cape, South Africa.
authors.forename: Naomi S
authors.initials: NS
authors.lastname: Levitt
mesh_terms: D001786:Blood Glucose / Q000378:metabolism; D015190:Blood Glucose Self-Monitoring; D003906:Developing Countries; D003920:Diabetes Mellitus / Q000378:metabolism / Q000628:therapy*; D006442:Glycated Hemoglobin / Q000378:metabolism; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D055118:Medication Adherence; D009043:Motor Activity; D010379:Peer Group; D011320:Primary Health Care; D011788:Quality of Life; D012111:Residence Characteristics; D012648:Self Care / Q000379:methods*; D020377:Self Efficacy; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human
keywords: DIABETES & ENDOCRINOLOGY; PRIMARY CARE; PUBLIC HEALTH