Barriers and facilitating factors influencing implementation of occupational therapy home assessment recommendations: A mixed methods systematic review.

Most included studies were in older adults; seven focused on people aged 65 and over and mean ages ranged from 36.5 to 89.2 years, so the findings may not apply to younger patients. Implementation was measured differently across studies, some as a plain yes or no and some counting partial implementation, and much of it relied on patients reporting what they had done rather than an independent check. That makes the 55% to 90% range hard to compare between studies or to use as a target. In every randomised trial in the review, treatment allocation was not concealed and neither the therapists nor the participants were blinded. In two studies the same unblinded therapist delivered treatment and rated whether it was implemented, and one study's assessor knew the group assignment. Two studies were pilots using convenience samples, two had samples too small for their analyses, and most studies had no control group at all. Interventions varied widely in what was assessed, how many visits, over what period, and whether equipment was funded, and these details were often not reported. Only studies published in English from 2000 onwards were included.

The authors declare no conflict of interest. The paper does not say who funded the review.

Do not read the 55% to 90% range as a benchmark for your service. The studies measured implementation in different ways, most relied on patients saying what they had done, and this review pooled what people reported helped or got in the way, rather than testing any strategy to improve uptake.