Barriers and facilitators influencing adherence to occupational therapy home assessment recommendations: a mixed methods systematic review protocol.

Abstract

To identify and describe the barriers and facilitators that influence adherence to recommendations provided as part of an occupational therapy home assessment. Home assessments, including environmental interventions, are commonly used by occupational therapists. Home assessment recommendations aim to support a patient's independence in their occupational roles and improve safety in the home. Research evaluating home assessments and adherence to recommended strategies is limited. However, low adherence has been associated with poorer outcomes including falls, deconditioning, and decreased function. This research aims to synthesize factors that influence adherence to home assessment recommendations. This review will consider all qualitative and quantitative studies that report on adherence to recommendations provided during occupational therapy home assessments. Studies will include adults (>18) and/or their caregivers, who live in the community and receive an occupational therapy home assessment. A mixed methods systematic review will be undertaken. Eight databases will be searched for studies published in English reporting on adherence following home assessments completed by occupational therapists published after January 2000. Study quality will be assessed using standardized JBI critical appraisal tools dependent on study design. Data extraction will be performed using a standardized tool, followed by data transformation. Data synthesis will follow the convergent integrated approach. All findings will be tabulated to explore factors that influence adherence. PROSPERO CRD42020159233.