The use of Experience-based Co-design with Patients and Health Care Professionals in Development of an Intervention for Integrated HIV and NCDs Care in Health Care Settings: A Systematic Review

Abstract

Introduction The rising burden of comorbidities of HIV and NCDs, such as hypertension and diabetes mellitus, particularly in resource-limited settings, is the cause of high mortality rates. To curb the mortality rates and improve health outcomes of people living with HIV and NCDs, involvement of patients and the health care professionals in patient-centred care interventions aimed at improving the health outcomes is key. The objective was to systematically review and synthesise the evidence on the use of Experience-Based Co-Design (EBCD) with patients and healthcare professionals in the development of interventions to integrate HIV and NCD care within healthcare settings. Methods A systematic review was conducted using five electronic databases (Scopus, Proquest, PubMed, Web of Science, and Ebscohost) covering data from January 2014 to December 2024. Among 591 identified records, 10 studies met the eligibility criteria. The review followed PRISMA guidelines and was registered on Covidence (26 February 2025). Results None of the reviewed studies fully implemented EBCD; partial patient engagement features were observed. Most interventions were expert-driven and disease-specific, developed through integration of research findings rather than co-design, due to resource constraints, limited funding, and lack of researcher skills in EBCD. Discussion This highlights a gap in participatory approaches for integrated HIV-NCD care. The absence of EBCD in intervention development highlights the need for frameworks that actively engage patients and healthcare professionals in designing integrated, patient-centred care models. Conclusions Strengthening participatory approaches could enhance health outcomes and reduce mortality among individuals living with multimorbidity in resource-constrained settings.