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Do clinical guidelines guide clinical practice in stroke rehabilitation? An international survey of health professionals


Lynch, EA and Connell, LA and Carvalho, LB and Bird, M-L, Do clinical guidelines guide clinical practice in stroke rehabilitation? An international survey of health professionals, Disability and Rehabilitation Article ePub ahead of print. ISSN 0963-8288 (2021) [Refereed Article]

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Copyright 2021 Informa UK Limited, trading as Taylor & Francis Group

DOI: doi:10.1080/09638288.2021.1891304


Purpose: To identify health professionals awareness of stroke rehabilitation guidelines, and factors perceived to influence guideline use internationally.

Methods: Online survey study. Open-ended responses were thematically analysed, guided by the Consolidated Framework for Implementation Research.

Results: Data from 833 respondents from 30 countries were included. Locally developed guidelines were available in 22 countries represented in the sample. Respondents from high-income countries were more aware of local guidelines compared with respondents from low- and middle-income countries. Local contextual factors such as management support and a culture of valuing evidence-based practice were reported to positively influence guideline use, whereas inadequate time and shortages of skilled staff inhibited the delivery of guideline-recommended care. Processes reported to improve guideline use included education, training, formation of workgroups, and audit-feedback cycles. Broader contextual factors included accountability (or lack thereof) of health professionals to deliver rehabilitation consistent with guideline recommendations.

Conclusion: While many health professionals were aware of clinical guidelines, they identified multiple barriers to their implementation. Efforts should be made to raise awareness of local guidelines in low- and middle-income countries. More attention should be paid to addressing local contextual factors to improve guideline use internationally, going beyond traditional strategies focused on individual health professionals.IMPLICATIONS FOR REHABILITATIONSystems are required so people and organisations are held accountable to deliver evidence-based care in stroke rehabilitation.Locally developed stroke rehabilitation guidelines should be promoted to boost awareness of these guidelines in low- and middle-income countries.In all regions, strategies to influence or adapt to the local setting, are required to optimise guideline use.

Item Details

Item Type:Refereed Article
Keywords:practice guidelines as topic, evidence-based practice, guidelines as topic, professional practice, rehabilitation, stroke, stroke rehabilitation
Research Division:Biomedical and Clinical Sciences
Research Group:Neurosciences
Research Field:Neurology and neuromuscular diseases
Objective Division:Health
Objective Group:Public health (excl. specific population health)
Objective Field:Preventive medicine
UTAS Author:Bird, M-L (Dr Marie-Louise Bird)
ID Code:144268
Year Published:2021
Deposited By:Health Sciences
Deposited On:2021-05-05
Last Modified:2021-06-09

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