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Cited by 20Health and Conflict StudiesGlobal Health and EpidemiologyChronic Disease Management Strategies

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A systematic review of effective strategies for chronic disease management in humanitarian settings; opportunities and challenges

Asgary, Ramin, Garland, Victoria, Ro, Vicky, Stribling, Judy Carole, Waldman, Ronald·2022·Preventive Medicine
DOI 10.1016/j.ypmed.2022.107154
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Abstract

Large number of people with non-communicable diseases (NCDs) face barriers to adequate healthcare in humanitarian settings. We conducted a systematic literature review in MEDLINE/PubMed, Web of Science, EMBASE/DARE, Cochrane, and grey literature from 1990 to 2021 to evaluate effective strategies in addressing NCDs (diabetes, cardiovascular diseases, COPD, cancer) in humanitarian settings. From 2793 articles, 2652 were eliminated through title/abstract screening; 141 articles were reviewed in full; 93 were eliminated for not meeting full criteria. Remaining 48 articles were reviewed qualitatively to assess populations, settings, interventions, outcome, and efficacy and effectiveness; 38 studies addressed treatments, 9 prevention, and 7 epidemiology. Prevention studies broadly addressed capacity-building. Treatment and epidemiology studies largely addressed hypertension and diabetes. Interventions included web-based/mobile health strategies, pharmacy-level interventions, portable imaging, and capacity building including physical clinics, staff training, forging collaborations, guideline development, point-of-care labs, health promotion activities, EMR, and monitoring interventions. Collaboration between academia and implementing agencies was limited. Models of care were largely not well-described and varied between studies due to contextual constraints. Barriers to interventions included financial, logistical, organizational, sociocultural, and security. Cancer care is significantly understudied. Simplified care models adapted to contexts and program evaluations of implemented strategies could address gaps in applied research. Inherent challenges in humanitarian settings pose unavoidable perils to evidence generation which requires a shift in research mindset to match aspirations with practicality, research collaborations at the inception of projects, reworking of desired conventional level of research evidence considering resource-intense constraints (HR, time, cost), and adapted research tools, methods, and procedures.

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  • Emerging evidence suggests that AI-enabled applications can improve operational efficiency, clinical decision-making, patient triage, scheduling, and treatment planning when supported by appropriate governance, infrastructure, and workforce competencies.

    “Similarly, emerging evidence suggests that AI-enabled applications can improve operational efficiency, clinical decision-making, patient triage, scheduling, and treatment planning when supported by appropriate governance, infrastructure, and workforce competencies”

    From A Scoping Review of Implemented Innovations in Cancer Care: Implications for Pan-Canadian Scaling (2026) · cites this paper as [49]

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Metadata

Authors
Asgary, R., Garland, V., Ro, V., Stribling, J. C., & Waldman, R.
Affiliations
  • George Washington University (US)
  • Northwell Health (US)
  • Columbia University (US)
  • Weill Cornell Medicine (US)
Corresponding author
Asgary, Ramin
ORCID
Venue
Preventive Medicine
Publisher
Elsevier BV
Published
2022-08
Volume
161
Pages
107154
ISSN
0091-7435 (ISSN-L)
DOI
10.1016/j.ypmed.2022.107154
OpenAlex
W4284959012
Cited by
20
References
68
Citations by year
2026: 9 · 2025: 8 · 2024: 1 · 2023: 2
FWCI
0.53
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Preventive Medicine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Health Professions › General Health Professions › Health and Conflict Studies
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Global Health and Epidemiology
  • Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
Keywords
chronic disease management, humanitarian settings, non-communicable diseases, diabetes mellitus, hypertension, cardiovascular disease, chronic obstructive pulmonary disease, cancer care, mobile health, capacity building, point-of-care testing, models of care, barriers to care, resource-limited settings
MeSH terms
Chronic Disease, Diabetes Mellitus, Humans, Hypertension, Program Evaluation, Disease Management

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