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BMC Health Services Research
Published in: BMC Health Services Research 1/2024

Open Access 01-12-2024 | Stroke | Research

Is it possible to make ‘living’ guidelines? An evaluation of the Australian Living Stroke Guidelines

Authors: Louise Wiles, Peter D Hibbert, Yvonne Zurynski, Carolynn L. Smith, Gaston Arnolda, Louise A. Ellis, Rebecca Lake, Brona Nic Giolla Easpaig, Charlotte Molloy, Sandy Middleton, Jeffrey Braithwaite, Kelvin Hill, Tari Turner

Published in: BMC Health Services Research | Issue 1/2024

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Abstract

Background

Keeping best practice guidelines up-to-date with rapidly emerging research evidence is challenging. ‘Living guidelines’ approaches enable continual incorporation of new research, assisting healthcare professionals to apply the latest evidence to their clinical practice. However, information about how living guidelines are developed, maintained and applied is limited. The Stroke Foundation in Australia was one of the first organisations to apply living guideline development methods for their Living Stroke Guidelines (LSGs), presenting a unique opportunity to evaluate the process and impact of this novel approach.

Methods

A mixed-methods study was conducted to understand the experience of LSGs developers and end-users. We used thematic analysis of one-on-one semi-structured interview and online survey data to determine the feasibility, acceptability, and facilitators and barriers of the LSGs. Website analytics data were also reviewed to understand usage.

Results

Overall, the living guidelines approach was both feasible and acceptable to developers and users. Facilitators to use included collaboration with multidisciplinary clinicians and stroke survivors or carers. Increased workload for developers, workload unpredictability, and limited information sharing, and interoperability of technological platforms were identified as barriers. Users indicated increased trust in the LSGs (69%), likelihood of following the LSGs (66%), and frequency of access (58%), compared with previous static versions. Web analytics data showed individual access by 16,517 users in 2016 rising to 53,154 users in 2020, a threefold increase. There was also a fourfold increase in unique LSG pageviews from 2016 to 2020.

Conclusions

This study, the first evaluation of living guidelines, demonstrates that this approach to stroke guideline development is feasible and acceptable, that these approaches may add value to developers and users, and may increase guideline use. Future evaluations should be embedded along with guideline implementation to capture data prospectively.
Appendix
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Metadata
Title
Is it possible to make ‘living’ guidelines? An evaluation of the Australian Living Stroke Guidelines
Authors
Louise Wiles
Peter D Hibbert
Yvonne Zurynski
Carolynn L. Smith
Gaston Arnolda
Louise A. Ellis
Rebecca Lake
Brona Nic Giolla Easpaig
Charlotte Molloy
Sandy Middleton
Jeffrey Braithwaite
Kelvin Hill
Tari Turner
Publication date
01-12-2024
Publisher
BioMed Central
Keyword
Stroke
Published in
BMC Health Services Research / Issue 1/2024
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-024-10795-6

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