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NHMRC approves updates to standing, daily activities & antiplatelets

Recent changes to our clinical guideline recommendations for antiplatelet therapy, and recovery of standing and activities of daily living have been approved by the National Health and Medical Research Council (NHMRC). The NHMRC also noted minor changes to the wording of recommendations for fatigue and sexuality.

These updates are part of our world-first living guidelines project, funded by the Australian Government’s Medical Research Future Fund (MRFF). Newly published evidence was assessed by our content working groups and consumer panel for impact on the recommendations, with additional feedback provided through public consultation.

Thank you to everyone who provided feedback on the draft recommendations in March and April. Remember that you have until 30 July to comment on our current round of public consultation.

The latest published updates, including those approved by the NHMRC, cover five topics from different areas of stroke care:

  • Antiplatelet therapy (Chapter 4) – Restarting antiplatelet therapy can be considered after the acute phase of an intracerebral haemorrhage if the person was previously on antithrombotic therapy.
  • Standing (Chapter 5) – Recommendation for task-specific practice now split into a strong recommendation for activities that challenge balance, plus a weak recommendation for adding on virtual reality training, visual or auditory feedback or electromechanical assistance.
  • Activities of daily living (Chapter 5) – Updated from strong recommendation against to a weak recommendation against routinely using acupuncture to improve activities of daily living. In addition, a new weak recommendation against using selective serotonin reuptake inhibitors to reduce disability.
  • Fatigue (Chapter 6) – Minor wording changes and a mention of cognitive behavioural therapy as a possible intervention.
  • Sexuality (Chapter 8) – New evidence added, but no change in recommendation apart from minor wording changes.

The full living stroke guidelines can be accessed online at informme.org.au/guidelines.