Inclusion of rehabilitation approach in Japanese clinical practice guidelines: a descriptive analysis

Abstract

[Purpose] To investigate how well rehabilitation is described in Japanese clinical practice guidelines of various diseases or disorders requiring rehabilitation. [Participants and Methods] Clinical practice guidelines were extracted from the MINDS database (Japan Council for Quality Health Care). Japanese clinical practice guidelines of specific diseases or disorders requiring rehabilitation were included. The exclusion criteria were clinical practice guidelines on the procedure, symptoms, and/or medical examination. To select the clinical practice guidelines of diseases or disorders requiring rehabilitation, eight participants evaluated the need for rehabilitation for the disease or disorder through the modified Delphi method. They graded the necessity of rehabilitation from 1 to 9 (1, completely disagree; 9, completely agree). The clinical practice guidelines that had grades 7 or higher as the median were included in the analyses. Systematic reviews were compiled as an indicator of the extent to which rehabilitation is described in clinical practice guidelines. [Results] Forty-four clinical practice guidelines were selected, and 26 (59.1%) included descriptions of rehabilitation. There were 443 existing systematic reviews related to rehabilitation for each disease or disorder enrolled in the present study and 67 (15.1%) systematic reviews quoted in those guidelines. [Conclusion] Rehabilitation was not well described in the clinical practice guidelines of the diseases or disorders that require rehabilitation.

A cross-sectional survey of consistent rehabilitation through long-term care insurance in Japan: a questionnaire survey

“…In Japan, LTCI helps in the seamless transition between treatments from acute to chronic phases to improve and maintain functional activity of patients 6 . Disease-specific rehabilitation in each clinical department is widely recognized 7 and has been established in Japan 8 – 10 . Scarce evidence is available for successful rehabilitation using LTCI as opposed to medical insurance; however, success has been reported in different patients, including those with reduced dementia symptoms 11 , improved cognitive function 12 , and reduced fall risk and improved mobility 13 , 14 .…”