Stroke Rehabilitation and Patients with Multimorbidity: A Scoping Review Protocol

Abstract

Stroke care presents unique challenges for clinicians, as most strokes occur in the context of other medical diagnoses. An assessment of capacity for implementing “best practice” stroke care found clinicians reporting a strong need for training specific to patient/system complexity and multimorbidity. With mounting patient complexity, there is pressure to implement new models of healthcare delivery for both quality and financial sustainability. Policy makers and administrators are 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 Strategy’s Stroke Best Practice Recommendations. The recommendations provide a framework to facilitate the adoption of evidence-based best practices in stroke across the continuum of care. However, given the increasing and emerging complexity of patients with stroke in terms of multimorbidity, the evidence supporting clinical practice guidelines may not align with the current patient population. To evaluate this, electronic databases and gray literature will be searched, including published or unpublished studies of quantitative, qualitative or mixed-methods research designs. Team members will screen the literature and abstract the data. Results will present a numerical account of the amount, type, and distribution of the studies included and a thematic analysis and concept map of the results. This review represents the first attempt to map the available literature on stroke rehabilitation and multimorbidity, and identify gaps in the existing research. The results will be relevant for knowledge users concerned with stroke rehabilitation by expanding the understanding of the current evidence.

Stroke rehabilitation evidence and comorbidity: a systematic scoping review of randomized controlled trials

“…31 Drawing from methods outlined by Levac, Colquhoun and O'Brien's 32 advancement of Arksey and O'Malley's 31 methodological framework for scoping reviews, the search, screening and abstraction was conducted in a systematized way. The methods were systematic in that they followed a structured and explicit procedure and met many of the guidelines set out by Peters et al 33 for systematic scoping reviews; however, the protocol 34 was developed prior to the publication of these guidelines. Detailed methods were previously published 34 ; an overview of the method are outlined below.…”

“…The methods were systematic in that they followed a structured and explicit procedure and met many of the guidelines set out by Peters et al 33 for systematic scoping reviews; however, the protocol 34 was developed prior to the publication of these guidelines. Detailed methods were previously published 34 ; an overview of the method are outlined below.…”

An integrated hospital-to-home transitional care intervention for older adults with stroke and multimorbidity: A feasibility study

“…cost, safety, equity). 8,10,[25][26][27] Robust research studies using new, integrated TC interventions are needed to improve the experience and quality of transitioning from hospital to home for this vulnerable population.…”

Mapping the progress and impacts of public health approaches to palliative care: a scoping review protocol

“… 13 With that said, the strategy of reporting results from this review will draw on recent innovations in reporting scoping review results, such as from Halas et al 13 and Nelson et al . 14 Both of the aforementioned studies advocate using a modified version of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 15 to present results from the search process. We will also modify the PRISMA checklist, specifically by incorporating the elements of the checklist that are congruent with the underpinnings of scoping review methodology while removing points that are not, such as those points that relate to bias.…”

“…We will also modify the PRISMA checklist, specifically by incorporating the elements of the checklist that are congruent with the underpinnings of scoping review methodology while removing points that are not, such as those points that relate to bias. Drawing further on the work of Levac et al 11 and Nelson et al , 14 we will also present a numerical overview of the amount, type and distribution of the included studies. The central section of the review will comprise a thematic summary of the findings that relates the a priori and emergent categories extracted from the included studies to the research questions stated above.…”