Improving management of type 2 diabetes, hypertension and dyslipidaemia in the Caribbean: a systematic review of intervention studies

Objective To evaluate published interventions aimed at improving the management of type 2 diabetes, hypertension and dyslipidaemia in the Caribbean. Methods We conducted a systematic review of four databases in accordance with PRISMA guidelines. Inclusion criteria were conducted in the Caribbean among adults >= 18 years who had type 2 diabetes, hypertension or dyslipidaemia; controlled trials, interventions, or comparative studies with pre-post designs and reported on at least one of the clinical outcomes of interest. Results Seventeen studies met the criteria for inclusion. The majority were conducted in Cuba and Trinidad and Tobago, and 35% were conducted over 10 years ago. Samples were small and largely consisted of older adult females and patients with type 2 diabetes. Four of eight (50%) studies that reported on HbA1c, 5 of 12 (42%) that reported on blood pressure and 2 of 7 (29%) that reported on body mass index observed significant improvements. Study heterogeneity precluded our ability to conduct a meta-analysis. The overall quality of evidence based on GRADE criteria was low for all outcomes assessed. Conclusion There is insufficient evidence on interventions to address type 2 diabetes, hypertension and dyslipidaemia in the Caribbean.