How digital health solutions align with the roles and functions that support hospital to home transitions for older adults: a rapid review study protocol

Abstract

IntroductionOlder adults may experience challenges during the hospital to home transitions that could be mitigated by digital health solutions. However, to promote adoption in practice and realise benefits, there is a need to specify how digital health solutions contribute to hospital to home transitions, particularly pertinent in this era of social distancing. This rapid review will: (1) elucidate the various roles and functions that have been developed to support hospital to home transitions of care, (2) identify existing digital health solutions that support hospital to home transitions of care, (3) identify gaps and new opportunities where digital health solutions can support these roles and functions and (4) create recommendations that will inform the design and structure of future digital health interventions that support hospital to home transitions for older adults (eg, the pre-trial results of the Digital Bridge intervention; ClinicalTrials.gov Identifier: NCT04287192).Methods and analysisA two-phase rapid review will be conducted to meet identified aims. In phase 1, a selective literature review will be used to generate a conceptual map of the roles and functions of individuals that support hospital to home transitions for older adults. In phase 2, a search on MEDLINE, EMBASE and CINAHL will identify literature on digital health solutions that support hospital to home transitions. The ways in which digital health solutions can support the roles and functions that facilitate these transitions will then be mapped in the analysis and generation of findings.Ethics and disseminationThis protocol is a review of the literature and does not involve human subjects, and therefore, does not require ethics approval. This review will permit the identification of gaps and new opportunities for digital processes and platforms that enable care transitions and can help inform the design and implementation of future digital health interventions. Review findings will be disseminated through publications and presentations to key stakeholders.

Inclusion of Older Adults in Digital Health Technologies to Support Hospital-to-Home Transitions: Secondary Analysis of a Rapid Review and Equity-Informed Recommendations

“…A rapid review was deemed appropriate, given the need to generate timely recommendations for future digital health interventions, as the COVID-19 pandemic has prompted an immediate need for novel technological supports [ 21 , 50 , 51 ]. Consistent with prior studies that conducted a secondary analysis of reviews [ 52 - 54 ], a secondary analysis entailed reexamining relevant data to answer different research questions and addressing knowledge gaps identified in the initial review [ 55 ].…”

“…In the remainder of this section, we outline the specific steps undertaken to complete the review. As this secondary analysis aimed to answer different research questions than intended within the published protocol, the methods used in this study necessitated some deviations from the original protocol, as described in the following sections [ 21 ].…”

“…To help inform recommendations for future technologies to assist with hospital-to-home transitions for older adults, we conducted a secondary analysis of a rapid review of existing technologies. The protocol for this broader review has been published elsewhere [ 21 ]. The initial review mapped the published literature on studies that tested digital health interventions to support hospital-to-home transitions.…”

“…This review included all relevant interventions with samples of at least one older adult for comprehensiveness. Preliminary findings from the review indicated that less than one-fifth of the included studies were conducted exclusively with older adults and highlighted the need to explicitly examine interventions with older adults [ 21 ]. The broader review did not consider sex nor gender in its analysis, nor any other intersectional factors that influence participation in digital technology interventions.…”

“…The broader review did not consider sex nor gender in its analysis, nor any other intersectional factors that influence participation in digital technology interventions. A secondary analysis focusing on sex, gender, and other intersectional factors was not part of the planned protocol [ 21 ]. Thus, the purpose of this secondary analysis was to (1) identify the characteristics of older adults targeted by studies testing the implementation of digital health interventions to support hospital-to-home transitions; (2) identify the characteristics of the samples included within studies testing digital health interventions to support hospital-to-home transitions; and (3) create recommendations for enhancing equity, diversity, and inclusion in future digital health intervention research.…”