SPECIAL INTEREST REPORT POSTER DISPLAY

THE DEVELOPMENT OF EVIDENCE BASED PRACTICE: A WEB BASED SOURCE OF CURRENT BEST EVIDENCE TO GUIDE REHABILITATION OF OLDER PEOPLE. Creed G, Adler B, Stott D; Academic section of Geriatric Medicine, Glasgow University, Glasgow, Scotland, UK

PURPOSE: There is a large amount of high quality research literature containing potentially valuable evidence to guide healthcare of older people. This information is difficult and time consuming to access and to understand. The overall purpose of this project is to encourage implementation of evidence based practice by providing an easily accessible source of reliable, current best evidence of the effectiveness of interventions employed in the care and rehabilitation of older people. The development of a database and website containing concise summaries of relevant evidence aims to break down the barriers that prevent health professionals and planners keeping up to date. RELEVANCE: Health professionals and planners of health services are responsible to decide what is best for their patients. Decisions should therefore be based not only on clinical expertise and the patients’ unique values and circumstances but also on the best current evidence. It is recognised that healthcare for older people is particularly complex due to the concurrent effects of aging and/or multi-pathologies, which makes the development of an easily accessible source of best evidence very relevant and necessary. DESCRIPTION: The comprehensive database and website is focused on answering specific clinical and organisational questions about effectiveness of interventions and services concerning older people. It is presented in TOPICS reflecting major common problems of older patients (e.g. falls). For each topic one or more relevant QUESTIONS are asked about the effectiveness (e.g. what is the effectiveness of providing hip protectors for people at risk of falling?) EVIDENCE STATEMENTS are developed for each INTERVENTION (e.g. hip protectors) based on the evidence found in the research literature. The project uses a systematic method of categorising the level of effectiveness and provides clear statements of the possible benefits and harms for each intervention. The concise evidence statements are backed up by enough detail to indicate strength and weaknesses of the research. At present the project is restricted to evidence from COCHRANE Systematic Reviews. To date just over 100 potentially relevant Systematic Reviews have been identified. The process is based on structured crtitical appraisal of the reviews and links are provided to the Cochrane Library and relevant National Guidelines. EVALUATION: The project is directed and peer reviewed by a local steering group that consists of healthcare professionals, academics, health service managers and planners. This group will continuously judge the utility of the evidence database by its application to the planning and delivery of effective health services for older people in Glasgow. CONCLUSIONS: Evidence based healthcare is essential for the improvement of health and independence of older people. The project is developing an easily accessible database and website answering clinical questions about effectiveness of different interventions in a systematic and concise manner based on critical appraisal of relevant Cochrane Systematic Reviews. The gaps in research evidence are also clearly identified. IMPLICATIONS: The development of this database supports clinical Physiotherapists and others working with older people to make informed decisions about treatment options while also providing an attractive educational tool for engagement with current research literature. KEYWORDS: Evidence based practice; Clinical effectiveness; Older people. FUNDING ACKNOWLEDGEMENTS: The project is funded by NHS Greater Glasgow. CONTACT: gcl561@clinmed.gla.ac.uk