Date Presented 04/03/2025
A scoping literature review using Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines evaluated home health assessments able to be administered by OTPs evaluating activities of daily living (ADLs) and instrumental activities of daily living (IADLs) for patients across diagnoses.
Primary Author and Speaker: Christine C. McNichols
Additional Authors and Speakers: Stacey Reynolds
Contributing Authors: Marianne Capps, Clair Martin, Erin Blankenship
PURPOSE: To demonstrate patient gains, improve or restore function, as well as provide justification and documentation for various insurance payors, there is a need to use validated assessments. The purpose of this scoping review was to ascertain what validated assessments are available for occupational therapists (OTs).
DESIGN: This was a scoping review based upon the methodology of the Preferred Reporting Items for Systematic Review and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR). Search strategy included any peer-reviewed full text available English language articles published through February 7th, 2024 (the date of extraction) that discussed ADL and/or IADL assessments/outcome measures that could be administered by an OT practitioner in the home health environment.
METHOD: All studies had inclusionary criteria of having been performed in the U.S. If a part of a systematic review, there had to be at least one study measuring ADLs and/or IADLs with a validated tool, or an assessment being validated with existing validated assessments from the U.S. Studies must have been performed in the patient’s home environment.
RESULTS: Out of the 84 studies included, 79 different assessments were used. The most frequently used assessments are as follows: Outcomes and Assessment Information Set (OASIS) (n = 23), Functional Independence Measure (FIM) (n = 11), Timed Up and Go (TUG) (n = 8), and Berg Balance Scale (BBS) (n = 7).
CONCLUSION: The most frequent domain(s) assessed were ADLs (n = 79). The most frequent ADL assessed was functional mobility (n = 112), while the most frequent IADL assessed was safety and emergency maintenance (n = 44). There is a need for occupational therapists to use validated assessments to document objective patient progress resulting from the impact of occupational therapy services.
IMPACT STATEMENT: This information will provide OTs with knowledge of what validated assessments are available to evaluate ADL and IADLs in the home setting.
References
Herman, B., Swope, K., McGlamery, J. N., Grote, C., & Grun, N. (2023). Home health. (R. Akselrud, Ed.). Quintessential Occupational Therapy: A Guide to Areas of Practice. SLACK, Incorporated. http://ebookcentral.proquest.com/lib/vcu/detail.action?docID=30404165
Centers for Medicare & Medicaid Services. (2022). Home health occupational therapy. https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?LCDId=34560
