Implementation interventions to promote the uptake of evidence-based practices in stroke rehabilitation (Review)
Cahill, Liana S., Carey, Leeanne M., Lannin, Natasha A., Turville, Megan, Neilson, Cheryl L., Lynch, Elizabeth A., McKinstry, Carol E., Xi Han, Jia and O'Connor, Denise. (2020). Implementation interventions to promote the uptake of evidence-based practices in stroke rehabilitation (Review). Cochrane Database of Systematic Reviews. (10), p. Article CD012575.
|Authors||Cahill, Liana S., Carey, Leeanne M., Lannin, Natasha A., Turville, Megan, Neilson, Cheryl L., Lynch, Elizabeth A., McKinstry, Carol E., Xi Han, Jia and O'Connor, Denise|
Data collection and analysis
We are uncertain if implementation interventions improve healthcare professional adherence to evidence‐based practice in stroke rehabilitation compared with no intervention as the certainty of the evidence was very low (risk ratio (RR) 1.19, 95% confidence interval (CI) 0.53 to 2.64; 2 trials, 39 clusters, 1455 patient participants; I2 = 0%). Low‐certainty evidence indicates implementation interventions in stroke rehabilitation may lead to little or no difference in patient adherence to recommended treatment (number of recommended performed outdoor journeys adjusted mean difference (MD) 0.5, 95% CI –1.8 to 2.8; 1 trial, 21 clusters, 100 participants) and patient psychological well‐being (standardised mean difference (SMD) –0.02, 95% CI –0.54 to 0.50; 2 trials, 65 clusters, 1273 participants; I2 = 0%) compared with no intervention. Moderate‐certainty evidence indicates implementation interventions in stroke rehabilitation probably lead to little or no difference in patient health‐related quality of life (MD 0.01, 95% CI –0.02 to 0.05; 2 trials, 65 clusters, 1242 participants; I2 = 0%) and activities of daily living (MD 0.29, 95% CI –0.16 to 0.73; 2 trials, 65 clusters, 1272 participants; I2 = 0%) compared with no intervention.
No studies reported the effects of implementation interventions in stroke rehabilitation on healthcare professional intention to change behaviour or satisfaction.
Five studies reported economic outcomes, with one study reporting cost‐effectiveness of the implementation intervention. However, this was assessed at high risk of bias. The other four studies did not demonstrate the cost‐effectiveness of interventions.
Tailoring interventions to identified barriers did not alter results.
We are uncertain of the effect of one implementation intervention versus another given the limited very low‐certainty evidence.
|Journal||Cochrane Database of Systematic Reviews|
|Journal citation||(10), p. Article CD012575|
|Publisher||John Wiley & Sons Ltd|
|Open access||Open access|
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File Access Level
|Online||15 Oct 2020|
|Publication process dates|
|Deposited||04 Jul 2023|
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