Hospital at home: A systematic review of how medication management is conceptualised, described and implemented in practice-A study protocol

IntroductionHospital at Home (H@H) is a method of healthcare delivery, where hospital level interventions are conducted in the patient's 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 analysisWe 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 disseminationThis 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).

Automated summary

Hospital at Home (H@H) is a method of healthcare delivery that provides hospital-level interventions in the patient's residence, offering an alternative to hospital admission. However, there is limited evidence supporting the delivery of medication management within the H@H model. This study aims to describe how medication management is conceptualized in H@H, identify key components of medication management, and explore the implementation variability within H@H models.