Long Oral Presentation ANZTS Trauma 2024 Conference

Clinical Practice Guideline Recommendations to Improve the Mental Health of Adult Trauma Patients: A Systematic Review (21632)

Melanie Berube 1 2 , Alexandra Lapierre 1 3 , Nori Bradley 4 , Meghean O'Donnell 5 , Laurence Bourque 1 , Mickael Thebaud 1 , Thomas Stelfox 6 , Lynne Moore 1 3 , Naisan Garraway 7 , Juanita Haagsma 8 , David Clarke 9 , Robert Green 10 , Jagadish Rao 11 , Nasira Lakha 7 , Helen-Maria Vasiliadis 12 , Michel Perreault 13 , Matthew Menear 1 14 , Léonie Archambault 13 , Hélène Provencher 1 15 , Alexis Turgeon 16 , Nelofar Kureshi 17 , Christine Genest 18 , William Panenka 19
  1. Faculty of Nursing, Laval University, QuébecCity, QUEBEC, Canada
  2. Faculty of Nursing, Laval University, Quebec City, Quebec, Canada
  3. Social andPreventive Medicine, Laval University, Quebec City, Quebec, Canada
  4. Trauma Surgery, University of Alberta, Edmonton, Alberta, Canada
  5. Psychiatry, University of Melbourne, Melbourne, Australia
  6. Faculty of Medicine & Dentistry , University of Alberta, Edmonton, Alberta, Canada
  7. Trauma Surgery, University of British Columbia, Vancouver, British Columbia, Canada
  8. Public Health, Erasmus University, Rotterdam, Netherlands
  9. Neurosurgery, Dalhousie University, Halifax, Nova Scotia, Canada
  10. Trauma surgery, Dalhousie University, Halifax, Nova Scotia, Canada
  11. Trauma Surgery, University of Regina, Regina, Saskatchewan, Canada
  12. Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada
  13. Psychiatry, McGill Université, Montreal, Quebec, Canada
  14. Faculty of Family and Emergency Medicine, Laval University, Quebec City, Quebec, Canada
  15. Faculty of Nursing, Laval University, Quebec City, Quebec, Canada
  16. Anesthesiology and Critical Care Medicine, Laval University, Quebec City, Quebec, Canada
  17. Interdisciplinary Studies, Dalhousie University, Halifax, Nova Scotia, Canada
  18. Faculty of Nursing, Université de Montréal, Montreal, Quebec, Canada
  19. Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada

Background:

Mental health disorders are common in adult trauma patients. To limit the associated burden, recognized authorities have issued recommendations through clinical practice guidelines (CPGs). However, the complexity of interpretating CPG scope and quality and optimizing mental health practices have limited the uptake of recommendations in the trauma population.

 

Aim:

To systematically review CPG mental health recommendations in the context of trauma care and appraise their quality.

 

Methods:

We searched CPGs through five databases, as well as guideline repositories and websites of trauma associations from January 2009 to March 2024. We targeted CPGs including at least one recommendation on the following domains: prevention, screening, assessment, intervention, patient and family engagement, referral, or follow-up procedure. We used the Appraisal of Guidelines Research and Evaluation (AGREE) II for CPGs quality assessment.

 

Results:

We included 44 CPGs, of which 22 (50%) were rated high quality. Included guidelines focused mainly on traumatic brain injury (TBI) (9;41%), orthopaedic trauma (6;27%), and spinal cord injury (SCI) (4;18%). There were 289 total recommendations, of which 62 (21%) were based on moderate to high quality evidence, covering all target domains. The domain with the highest number of recommendations was intervention, with 39 out of 62 (63%), mainly addressing the treatment of depression in TBI and SCI patients, and aggressive behavior in TBI patients.  

 

Conclusions:

We identified 62 recommendations based on moderate to high quality evidence, which should be considered for implementation in clinical settings. Our review also highlights the need for further research to optimize the mental health of trauma patients.