A systematic review and evaluation of post-stroke depression clinical practice guidelines

Abstract

ObjectivePost-stroke depression is a depressive mood disorder that follows a cerebrovascular accident and is a burden on stroke patients. Its management is included in clinical practice guidelines focused on stroke, and the recommended treatment is selective serotonin reuptake inhibitors in conjunction with psychotherapy. Clinical practice guidelines are recommendations used to standardize best medical practice, but there is no current evaluation of guidelines containing post stroke depression recommendations. Thus, the objective is to appraise the selected guidelines manner of development and quality. Materials and MethodsA systematic literature review across three databases and a manual google search was performed to collect guidelines that included recommendations on the management of post-stroke depression. 1236 guidelines were screened, and 27 were considered for inclusion. Considered guidelines were manually reviewed by the authors, and ultimately, 7 met inclusion criteria. The appraisal of guidelines for research and evaluation was used to evaluate these guidelines’ recommendations around post-stroke depression. ResultsThree guidelines met the threshold considered “High”, with all of them having five or more quality domains eclipse the cutoff score of 70%. Across all guidelines, the highest scoring domains were “Scope and Purpose”, “Clarity of Presentation”, and “Editorial Independence” with scores of 76.98%, 73.81%, and 91.36% respectively. The lowest scoring domains were “Applicability”, “Rigor of Development”, and “Stakeholder Involvement” with respective scores of 58.73%, 54.02%, and 43.90%. ConclusionsThe domains “Applicability”, “Rigor of Development,” and “Stakeholder Involvement” were the lowest scoring domains. These specific domains represent areas in which future guidelines could be more developed.