Guideline recommendations for oral care after stroke: A systematic review protocol

Introduction: There have been recent advancements in the development of guidelines for rehabilitation after stroke. Nevertheless, recommendations for specific practice areas such as oral care often lack adequate information for clinical processes and actions to attain evidence-based care.

Methods: We have developed a protocol to update a recent systematic review of clinical practice guidelines for stroke1 and to appraise existing recommendations for oral care provision. The search strategy includes a search of MEDLINE and EMBASE with MeSH and user-defined terms, 20 organizational and best-practice websites, and reference lists of accepted guidelines. Guideline appraisal will involve AGREE II ratings followed by a descriptive synopsis for oral care recommendations according to NHMRC evidence levels.

Results: Our preliminary search of databases and websites yielded 863 and 787 citations, respectively, for a total of 1650. Subsequent to abstract and full article review, we expect to identify high-quality stroke guidelines with recommendations for oral care provision.

Conclusion: Precise and attainable recommendations for oral care in stroke patients are urgently needed to prevent negative outcomes such as respiratory tract infections. Our appraisal of the level of evidence from oral care recommendations will support the development of initiatives and evidence-based practice across the continuum of care. We anticipate that our systematic review will provide insight and direction for implementation research.