key: cord-0321954-j0ci8wg7 authors: McGlen, S.; Lasserson, D.; Crowley, C.; AL Qamariat, Z.; Lim, R. title: Hospital at home: a systematic review of how medication management is conceptualised, described and implemented in practice - a study protocol date: 2022-05-10 journal: nan DOI: 10.1101/2022.05.10.22274917 sha: b8d0dadccebdcb20746aea4459d4286815a413c1 doc_id: 321954 cord_uid: j0ci8wg7 Introduction Hospital at Home (H@H) is a method of healthcare delivery, where hospital level interventions are conducted in the patients usual place of residence, offering an alternative to hospital admission. This often includes the ability to perform point of care diagnostics and treat conditions using a range of treatments traditionally associated with hospital admission, including intravenous medicines and oxygen. H@H services have been established worldwide but there is a wide variation in definition and delivery models and currently no documented evidence supporting the delivery of medicines and medicines management within the H@H model. Therefore, this study aims to 1) describe how medication management in H@H is conceptulised, 2) describe and identify key components of medication management in H@H and 3) describe and identify variability in the implementation of medication management services within H@H models Methods and Analysis We will search a range of databases (PubMed, Medline, Embase, CINAHL), publicly accessible documents and expert recommendations. Studies, reports and policy documents published between 1 st January 2000 and 31 st January 2022 will be included. Two independent reviewers will 1) screen and select studies based on a priori inclusion/exclusion, 2) conduct quality assessment using the Mixed Methods Appraisal Tool on included studies and 3) extract data. Inductive thematic analysis (objectives 1 and 2), the SEIPS 2.0 model (objective 2) and the Consolidated Framework for Implementation Research (objective 3) will be used to synthesise data. Ethics and dissemination This systematic review will use secondary data sources from published documents, and as such research ethical approval was not required. We will disseminate the findings of this study in a peer-reviewed journal and national/international conference(s). PROSPERO registration number : CRD42022300691 CC-BY 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. Inductive thematic analysis (objectives 1 and 2), the SEIPS 2.0 model (objective 2) and the 53 Consolidated Framework for Implementation Research (objective 3) will be used to synthesise 54 data. This systematic review will use secondary data sources from published documents, and as 58 such research ethical approval was not required. We will disseminate the findings of this 59 study in a peer-reviewed journal and national/international conference(s). CC-BY 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. Strengths and limitations of this study 64 • The search will be performed on a comprehensive range of databases and relevant 65 information sources to capture a global perspective relating to Hospital at Home (H@H). • A wide range of search terms will be used in our search, however due to the changing 67 nature of H@H, some terms may be unintentionally missed. • Only published literature will be synthesized in this systematic review, and it is recognised 69 that in a rapidly changing environment not all practices will be captured in written form. Research will be used to provide a system-level analysis of studies. • The study team consists of four pharmacists from a range of practice and research 74 backgrounds and a H@H consultant, therefore, will benefit from different perspectives on 75 the topic area. . CC-BY 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The search results will be collated on a web based systematic review tool 176 (https://www.rayyan.ai/), and duplicates removed. Independent screening of titles and 177 abstracts will be conducted by two researchers applying pre-specified inclusion and exclusion 178 criteria. Where there are disagreements about eligibility of papers, a third reviewer will assess 179 the paper a consensus method used to determine inclusion. Full-text articles of remaining 180 references will then be obtained and screened independently by two researchers using the 181 same inclusion/exclusion criteria and any disagreements will be resolved by discussion to 182 achieve consensus. For objective 1 (to describe how medication management in H@H is conceptulised) and 201 objective 2 (to describe and identify key components of medication management in H@H), all 202 sections of eligible papers will be read and coded inductively using thematic synthesis [23] . In 203 addition, to meet objective 2, the Systems Engineering Initiative for Patient Safety (SEIPS) 2.0 204 model [24] will be used to code textual data deductively. The SEIPS 2.0 model is a generic . CC-BY 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. The copyright holder for this preprint this version posted May 10, 2022. ; https://doi.org/10.1101/2022.05.10.22274917 doi: medRxiv preprint 8 205 system model that shows the elements of a work system and types of work processes that 206 may be required to produce a range of outcomes for different stakeholders. Analyses based 207 on the SEIPS 2.0 model will add to the inductive analysis, to close any potential gaps in our 208 interpretation of findings reported in eligible papers. Objective 3 focuses on the complex area of implementation of interventions and in this study, 211 the implementation of medication management services within H@H models globally. Therefore, the Consolidated Framework for Implementation Research (CFIR) will be used to The systematic review will be based on published data and no patients or members of the 221 public were/will be involved in the design of the study, interpretation or dissemination of 222 the findings. This systematic review will use secondary data sources from published documents, and as 226 such research ethical approval was not required. We will disseminate the findings of this study 227 in a peer-reviewed journal and national/international conference(s). Kings Fund (2021) Health and care in 2021: what can we expect Covid-19: Recovery and resilience in healthcare No place like home: Hospital at home 288 as a post-pandemic frontier for care delivery innovation Is comprehensive geriatric 291 assessment admission avoidance hospital at home an alternative to hospital admission for 292 older persons? UK Hospital at Home society (2022) What is hospital at home? Available online at Guidance note: frailty virtual ward (Hospital at Home for those living 296 with frailty) CMS announces comprehensive 299 strategy to enhance Hospital capacity amid Covid-19 surge Preferred reporting items for systematic 303 review and meta-analysis protocols (PRISMA-P) 2015 statement Mixed Methods Appraisal Tool (MMAT), Version 2018 Canadian Intellectual Property Office Methods for the thematic synthesis of qualitative research in 309 systematic reviews SEIPS 2.0: a human factors framework for 312 studying and improving the work of healthcare professionals and patients International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity 230 SM, RL and CC conceived the idea for the study. All authors collaborated in designing the 231 study. The protocol was drafted by SM, CC, ZA and RL. All authors contributed to the critical 232 revision of the manuscript. All authors read and approved the final manuscript. RL is the 233 guarantor of the review.. CC-BY 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review)The copyright holder for this preprint this version posted May 10, 2022. Competing interests 239 The authors declare that they have no competing interests. . CC-BY 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review)The copyright holder for this preprint this version posted May 10, 2022. ; https://doi.org/10.1101/2022.05.10.22274917 doi: medRxiv preprint