Authors' objectives: This health technology assessment evaluates the effectiveness and safety of continual long-term physiotherapy for adults after a diagnosis of stroke. It also evaluates the budget impact of publicly funding continual long-term physiotherapy after stroke and the experiences, preferences, and values of people who have had a stroke.

Authors' results and conclusions: Results We did not find any published studies that met the specific clinical inclusion criteria. We did not identify any studies that compared the cost-effectiveness of continual long-term versus short-term physiotherapy after stroke. The budget impact of publicly funding continual long-term physiotherapy after stroke in Ontario over the next 5 years ranges from $445,000 in year 1 at an uptake rate of 8% to $888,000 in year 5 at an uptake rate of 16%. The people who had been diagnosed with stroke with whom we spoke reported that they had benefitted from continual long-term physiotherapy. Conclusions We did not identify studies that addressed the specific research question. Based on the clinical evidence review, we are unable to determine the benefits of continual long-term compared with short-term physiotherapy after stroke. The cost-effectiveness of continual long-term physiotherapy after stroke in Ontario is unknown. We estimate that publicly funding continual long-term physiotherapy after stroke in Ontario would result in additional costs of between $445,000 and $888,000 annually over the next 5 years. Patients and caregivers who we spoke with felt that patients who have experienced a stroke should be able to continue with physiotherapy.

Authors' recommendations: The Quality business unit at Ontario Health, based on guidance from the Ontario Health Technology Advisory Committee, recommends ensuring that public funding for post-stroke physiotherapy is consistent with the recommendations in the 2016 Quality-Based Procedures: Clinical Handbook for Stroke (Acute and Postacute) to allow for equitable access and availability of this service. The Quality business unit at Ontario Health further recommends that the Ministry of Health clarify any applicable policies for receiving publicly funded physiotherapy for rehabilitation after a stroke

Authors' methods: We performed a systematic literature search of the clinical evidence. We also performed a systematic literature search of the economic evidence. We did not conduct a primary economic evaluation because there was insufficient clinical evidence. We also analyzed the budget impact of publicly funding continual long-term physiotherapy after stroke in Ontario. To contextualize the potential value of continual long-term physiotherapy after stroke, we spoke with people who had been diagnosed with stroke, as well as their caregivers.

Project Status: Completed

URL for project: https://www.hqontario.ca/evidence-to-improve-care/health-technology-assessment/reviews-and-recommendations/continual-long-term-physiotherapy-after-stroke

Year Published: 2020

URL for published report: https://www.hqontario.ca/evidence-to-improve-care/health-technology-assessment/reviews-and-recommendations/continual-long-term-physiotherapy-after-stroke

Requestor: Ontario Health Technology Advisory Committee (OHTAC); Ontario Ministry of Health

URL for additional information: https://www.hqontario.ca/evidence-to-improve-care/health-technology-assessment/reviews-and-recommendations/continual-long-term-physiotherapy-after-stroke

English language abstract: An English language summary is available

Publication Type: Full HTA

Country: Canada

Province: Ontario

Pubmed ID: 32194882

Organisation Name: Ontario Health

Contact Address: 525 University Ave, Toronto, ON M5G 2L3

Contact Name: Nancy Sikich, Director Health Technology Assessment

Contact Email: oh-hqo_hta@ontariohealth.ca

Copyright: © Queen’s Printer for Ontario, 2020 The copyright for all Ontario Health publications is owned by the Queen’s Printer for Ontario. Materials may be reproduced for commercial purposes only under a licence from the Queen’s Printer. For further information or to request a licence to reproduce content, please contact: Senior Copyright Advisor Publications Ontario 416-326-5153 copyright@ontario.ca