Incorporating evidence-based rehabilitation into clinical practice guidelines
Mari Honkanen, Jari Arokoski, Raija Sipilä, Katriina Kukkonen-Harjula, Antti Malmivaara, Jorma Komulainen
Current Care Guidelines, The Finnish Medical Society Duodecim, 00100 Helsinki, Finland. E-mail: firstname.lastname@example.org
Objective: Rehabilitation is often neglected in clinical practice guidelines, even when there is evidence for its effectiveness. The Current Rehabilitation development project, documented in this article, aimed to develop processes and structures to incorporate evidence and good practice on rehabilitation and functional capacity into the Finnish national Current Care Guidelines.
Design: Descriptive assessment.
Methods: The 3-year Current Rehabilitation development project was launched in 2012. It began with an assessment of existing rehabilitation evidence on the Current Care Guideline database and a query to Finnish rehabilitation experts. The project group developed and compiled tools for Current Care editors and guideline panels. The editorial team continued to monitor changes in rehabilitation evidence in the guidelines.
Results: During the years 2012–2014, a total of 54 guidelines were published, and rehabilitation was incorporated into 31 of them. The number of rehabilitation-related evidence summaries increased from 49 to 164. During the next 3 years an additional 41 guidelines were published. Rehabilitation was incorporated to 24 of them, and the number of rehabilitation-related evidence summaries increased from 78 to 136.
Conclusion: The level of evidence criteria used for rehabilitative interventions were the same as for symptomatic or curative interventions. Evidence showing the effectiveness of rehabilitation increased substantially during the project.
Current Care Guidelines are national clinical practice guidelines produced in Finland for the use of healthcare professionals and lay people. This article describes the 3-year “Current Rehabilitation” development project, which aimed to develop processes and structures to include rehabilitation in Current Care Guidelines. The results of the project were monitored for a further 3 years. The project group developed tools and provided training for guideline editors and guideline panels. The guideline panels drafted new or updated guidelines and included rehabilitation, when appropriate, with the help of the new tools. A total of 54 guidelines were published during the 3-year project, and 31 included a chapter on rehabilitation. The number of evidence summaries increased by 115 (from 49 to 164). This project shows that, through targeted action, more evidence of rehabilitation interventions can be included in clinical practice guidelines.
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