A Systematic Review of Quality Dementia Clinical Guidelines for the Development of WHO’s Package of Interventions for Rehabilitation

The Gerontologist · 7 authors, 8 centres

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The study systematically reviewed clinical practice guidelines (CPGs) for dementia published between 2010 and 2020 to identify rehabilitation interventions for the WHO's Package of Interventions for Rehabilitation. Limitations included gaps in evidence quality and scope for interventions in education, vocation, community life, and lifestyle modifications. The findings highlight a need for more rigorous research and guideline development in dementia rehabilitation, especially for neglected areas.

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systematic_review

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neurology

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ORIGINAL PAPER

PMC10581378

A Systematic Review of Quality Dementia Clinical Guidelines for the Development of WHO’s Package of Interventions for Rehabilitation

The Gerontologist

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ABSTRACT

Abstract Background and Objectives As part of the WHO Rehabilitation 2030 call for action, the WHO Rehabilitation Programme is developing its Package of Interventions for Rehabilitation (PIR) to support ministries of health around the globe in integrating rehabilitation services into health systems. As a vital step for this PIR development, we conducted a systematic review of clinical practice guidelines (CPGs) for dementia to identify interventions for rehabilitation and related evidence. Research Design and Methods Following WHO Rehabilitation Programme and Cochrane Rehabilitation’s methodology, quality CPGs published in English between January 2010 and March 2020 were identified using PubMed, Embase, CINAHL, PEDro, Google Scholar, guideline databases, and professional society websites. Guideline quality was assessed using the Appraisal of Guidelines for Research and Evaluation (II). Results Of the 22 CPGs that met the selection criteria, 6 satisfied the quality evaluation. Three hundred and thirty rehabilitation-related recommendations were identified, mostly concentrated in the areas of cognition, emotion, and carer support. There were many strong interventions, with moderate- to high-quality evidence that could be easily introduced in routine practice. However, major limitations were found both in the quality of evidence and scope, especially in areas such as education and vocation, community and social life, and lifestyle modifications. Discussion and Implications Further rigorous research is needed to build quality evidence in dementia rehabilitation in general, and especially in neglected areas for rehabilitation. Future work should also focus on the development of CPGs for dementia rehabilitation. A multipronged approach is needed to achieve Universal Health Coverage for dementia rehabilitation. Keywords: Dementia, Guidelines, Recommendations, Rehabilitation, Systematic review, Universal Health Coverage

CITATION EXPORT

Yun-Hee Jeon, Luisa Krein, Claire M C O’Connor et al.. A Systematic Review of Quality Dementia Clinical Guidelines for the Development of WHO’s Package of Interventions for Rehabilitation. The Gerontologist. (2022). https://doi.org/10.1093/geront/gnac105

AUTHORS

7 · 8 CENTRES

Yun-Hee Jeon, Luisa Krein, Claire M C O’Connor, Loren Mowszowski, Shantel Duffy, Katrin Seeher, Alexandra Rauch

1 Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
2 Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
3 Centre for Positive Ageing, HammondCare, Sydney, Australia
4 School of Population Health, University of New South Wales, Sydney, Australia
5 Brain and Mind Centre & School of Psychology, The University of Sydney, Sydney, Australia
6 School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
7 Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
8 Rehabilitation Programme, World Health Organization, Geneva, Switzerland

Yun-Hee Jeon, Luisa Krein, Claire M C O’Connor et al.. A Systematic Review of Quality Dementia Clinical Guidelines for the Development of WHO’s Package of Interventions for Rehabilitation. The Gerontologist. (2022). https://doi.org/10.1093/geront/gnac105