Applying Clinical Practice Guidelines to the Complex Patient: Insights for Practice and Policy from Stroke Rehabilitation

Oh you poor babies, having to deal with real world patients. Survivors have it much worse, having to deal with doctors that don't know one damn thing about stroke recovery.
https://www.researchgate.net/profile/Michelle_Nelson9/publication/307951994_IMPROVING_EVIDENCE_AND_MEASURES_OF_PERFORMANCE_Applying_Clinical_Practice_Guidelines_to_the_Complex_Patient_Insights_for_Practice_and_Policy_from_Stroke_Rehabilitation/links/57d2e8f008ae0c0081e26ad0.pdf

Abstract

In Canada, policy makers are working to align services with the Stroke Rehabilitation Best Practice Recommendations (SRBPR). Complicating the application of clinical practice guidelines (CPGs) is the fact that most strokes occur in the context of other diagnoses. We sought to understand clinicians’ use of the CPGs and ascertain how much guidance regarding multimorbidity was available in the SRBPR. Study results  indicated  that  using  the  recommendations was problematic due to a perceived lack of guidance regarding comorbidities and multimorbidity, and concerns regarding

the applicability to “real-life patients.” Comorbidities were mentioned in less than half of the recommendations, but no explicit guidance was provided regarding the management

of comorbidities. Given the prevalence of multimorbidity in stroke rehabilitation, this clinical context is ideal for development and testing of CPGs that account for multimorbidity and  other  complexity  factors.  Results  may  also  suggest limitations to using CPGs in the development of activity-

based funding models.