A review of international clinical guidelines that inform the use of assistive technology to support adults living with progressive or complex conditions.

Abstract

Objective: Adults living with progressive or complex conditions experience functional impairments that can impact activities and participation. Assistive technology (AT) is one intervention demonstrated to optimise functioning and reduce disability experienced. This study aimed to identify and characterise international evidence-based clinical practice guidelines (CPGs) which included recommendations on AT interventions for adults with progressive or complex conditions.

Methods: A published a priori review protocol guided searches of four electronic databases and 11 CPG portals. CPGs published between January 2012 and September 2023 in English for adults with progressive or complex conditions were included. Recommendations were catalogued according to: author, year and country of publication; grading of recommendations made; number of recommendations made overall and number pertaining to AT; target condition and/or population; age group/s recommendations related to (if specified); type of AT (categorised into "cognition", "communication", "vision", "hearing", "self-care", "mobility", "combination" or "other"); target professions to apply recommendations; evidence grading; and reference to supporting evidence. AT-related recommendations were summarised narratively. Analysis of the 18 CPGs that met inclusion criteria demonstrated that only 163 (7%) of the total 2,197 recommendations identified pertained to AT. Vocabulary used to describe AT, and detail offered regarding AT interventions was varied impacting the value of some AT-related CPGs.

Impact: This is the first review internationally to identify and document CPG recommendations for adults with progressive or complex conditions, specific to AT interventions. Guidance on types of assistive products - and personnel required for provision - was limited. Further evidence is required to guide practice.