How effective was implementation of the package of essential non-communicable disease (PEN) interventions: A review of evidence?

Summary Aims This paper reviewed the outcomes, cost-effectiveness and challenges of implementation of WHO PEN protocol in LMICs. Methods MEDLINE databases, the Cochrane Central Register of Controlled Trials and Google Scholar were searched and content analysis of the included studies was done. Results A total of 14 articles were included. Lack of essential medicines and manpower, poor recording and mis-calculation of CVD risk score, suboptimal recording of patient information and loss-to-follow-up were the key challenges reported in various PEN implementation settings. Conclusion The study has highlighted concerns and recommendations which need to be addressed before scale up.