Hennick Bridgepoint Hospital

Stroke Rehab Best Practice Recommendations

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How applicable are the stroke rehabilitation best practice guidelines for a person with multipleDefining Complexity in Stroke Rehab Poster chronic conditions?  What treatment recommendations are available for clinicians providing rehabilitation to patients with multiple chronic conditions?

Policy makers and administrators are increasingly turning to clinical practice guidelines to support decision making and resource allocation.  Stroke rehabilitation programs across Canada are being transformed to better align with the Canadian Stroke Best Practice Recommendations. The best practice recommendations are intended for use by heath care professionals and program administrators, providing care to patients affected by a stroke.

Multimorbidity has been identified as one of the major challenges facing clinical practice guidelines. Although quality assurance initiatives encourage concordance with evidence based practice guidelines, there are challenges when applying guidelines developed for the treatment of single diseases in the care of patients with multiple chronic conditions. The high quality evidence on which most guidelines are founded is largely based on relatively short term randomized clinical trials where the elderly or those with comorbid conditions comprise the exclusion criteria.

The study found that rehabilitation clinicians question the applicability of the best practices to their patients and reported relying on their sound clinical judgment, teamwork and creativity to develop treatment plans for multimorbid patients. 

Researcher: Michelle Nelson