Abstracts Presented at the SMART STROKES 2017 Conference, 10–11 August 2017, Gold Coast, QLD
Jolliffe, Laura, Lannin, Natasha A., Cadilhac, Dominique, Hoffmann, Tammy; id_orcid 0000-0001-5210-8548 · International Journal of Stroke · 2017
Background: Clinical practice guidelines (CPGs) contain recommendation statements which aim to optimise patient care. In stroke rehabilitation there are a number of CPGs internationally, however less is known about how similar they are nor about which guidelines to implement into practice. Aims: This study aimed to determine the quality, scope and consistency of clinical practice guideline recommendations for stroke rehabilitation. Method: Systematic review of CPGs for inpatient rehabilitation and/or community rehabilitation for adults with stroke or any other acquired brain injury diagnosis. Electronic databases (n = 2), guideline organisations (n = 4), and websites of professional societies (n = 17) were searched up to March 2016. The Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument and textual synthesis were used to appraise and compare recommendations. Results: From 411 papers, 20 papers comprising of 19 guidelines met the inclusion criteria. Only three guidelines rated high (>75%) across all domains of AGREE-II. ‘Scope and purpose’ and ‘clarity’ domains rate highest (87%, SD 12.4 and 72.2%, SD 18.9 respectively) with ‘applicability’ domain rating the lowest (37%, SD 34.6). Recommendations on assessment and motor therapies were consistent, guidelines varied in the level of detail and breadth of rehabilitation. Conclusion: Stroke guidelines are consistent in scope, but variable with respect to recommendations, methodological quality and applicability. Clinicians should be mindful that their local guideline might not contain all available evidence.