Background and purpose: Despite the presence of both national and regional clinical practical guidelines (CPGs) in Sweden, no previous studies have investigated the quality of CPGs or the level of agreement between national and regional CPGs. This study aimed to examine the quality of national CPGs recommending prosthetics and orthotics (P&O), and; quantify agreement between national and regional CPGs in Sweden.

Materials and Methods: National and regional CPGs were identified in public databases and by surveyed local Nurse Practitioners. Quality of the national guidelines was assessed by using AGREE II. Agreement between recommendations in the national and regional CPGs were quantified on a four-grade rating scale ("similar", "partially similar", "not similar/not present" and "different").

Results: Of 18 national CPGs, three CPGs (CPGs of Diabetes, Musculoskeletal disorders and Stroke) had nine recommendations related to P&O. The Musculoskeletal disorders and Stroke CPGs had quality scores >60% in all domains and the Diabetes CPG had scores >60% in five out of six domains according to AGREE II. Seven regional CPGs for P&O treatment were identified. Three national recommendations (in Diabetes CPG) showed "similar" content for all regions and two national recommendations (in Diabetes CPG) showed "not similar" content for all regions. The remaining four national recommendations (in Diabetes, Musculoskeletal disorders and Stroke CPGs) had varying agreement with regional CPGs.

Interpretation: There is a limited number of national recommendations for treatment within P&O. There was variation in the agreement of P&O-related recommendations in national and regional CPGs, which might lead to unequal care throughout the national healthcare system.