title: The effects of shifting tasks from pharmacy to non-pharmacy personnel for providing antiretroviral therapy to people living with HIV: a systematic review protocol.
abstract: BACKGROUND
  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
  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.
  
  
  BACKGROUND
  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.
  
  
  BACKGROUND
  CRD42015017034.
authors.affiliation: Cochrane South Africa, South African Medical Research Council, Tygerberg, South Africa Faculty of Medicine and Health Sciences, Centre for Evidence-based Health Care, Stellenbosch University, Cape Town, South Africa.
authors.forename: Nyanyiwe M
authors.initials: NM
authors.lastname: Mbeye
authors.affiliation: Cochrane South Africa, South African Medical Research Council, Tygerberg, South Africa.
authors.forename: Tamara
authors.initials: T
authors.lastname: Kredo
authors.affiliation: Cochrane South Africa, South African Medical Research Council, Tygerberg, South Africa Faculty of Medicine and Health Sciences, Centre for Evidence-based Health Care, Stellenbosch University, Cape Town, South Africa.
authors.forename: Charles S
authors.initials: CS
authors.lastname: Wiysonge
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use*; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D015201:Meta-Analysis as Topic; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010594:Pharmacies; D011203:Poverty; D012107:Research Design; D000078202:Systematic Reviews as Topic; D000078329:Workforce
chemical_list: D019380:Anti-HIV Agents
keywords: antiretroviral therapy; dispensing and distribution; lay providers; pharmacy personnel; task shiftng