The current landscape and opportunities in gastrostomy care quality improvement in low- and middle-income countries: a scoping review.

Abstract

This scoping review examined gastrostomy tube use and care practices in low- and middle-income countries (LMICs) to identify complications, barriers and strategies to improve patient outcomes. Guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews framework, six electronic databases were searched for studies published between 2000 and 2024. Of 1805 identified articles, 18 met the inclusion criteria and were classified into two themes: gastrostomy tube indications, techniques and outcomes; and care quality assessments and interventions. Patient outcome studies reported that adult complication rates ranged from 10% to 25%, with overall mortality from 0% to 48%, while paediatric complication rates ranged from 10% to 55%. Care quality studies identified gaps in nursing practices, protocol adherence and caregiver training. Interventions proposed included multidisciplinary care models and structured training programs for providers and caregivers. These findings highlight opportunities to improve gastrostomy outcomes in LMICs through establishing culturally sensitive and well-trained multidisciplinary care teams, implementing standardized protocols and caregiver engagement.