Community-based solutions for chronic disease management during natural disasters: A systematic review

Despite rapid increases in both the burden of chronic disease and climate change-driven extreme weather events globally, the need to jointly address these crises remains largely overlooked. Chronic diseases require ongoing and often specialized care, which natural disasters disrupt by increasing physiological stressors and disrupting access to healthcare facilities, food, shelter and medications. Community-based solutions can mitigate these health risks, especially in low-resource settings and among historically underserved populations. This systematic review aimed to identify key recommendations for community-based interventions that aid with chronic disease management during extreme weather events. A comprehensive search strategy was used to yield 46 eligible studies from 266 search results from Embase, PubMed and Google Scholar. Articles were included if they discussed chronic diseases, community-based solutions and natural disasters and excluded if they were not English-language and/or not published in a peer-reviewed journal. Articles were assessed and selected using PRISMA guidelines, and their quality was assessed using the Joanna Briggs Institute Critical Appraisal Tools. The final sample of studies represented 19 countries and consisted of four quantitative, 35 qualitative and seven mixed-method studies. Minimal quantitative data was a key limitation of this review and topic, which requires further research. From the selected studies, a narrative synthesis approach was used to derive nine themes of solutions. Findings reflected the highest number of interventions and recommendations targeting patient education, continuity of medication management, stakeholder collaboration and digital health.