Efficacy of occupational therapy prescribed home modifications: A systematic review

Ms Rebecca Nicks1, Ms Belinda Robertson1,2, Associate Professor Natasha Lannin1,3

1Alfred Health, Prahran, Australia, 2Flinders University, Adelaide, Australia, 3La Trobe University, Bundoora, Australia



To determine if home modifications prescribed by occupational therapists increase independence in activities of daily living, reduce fall rates and improve quality of life.


A systematic review with meta-analysis was conducted. Four electronic databases (Medline, CINAHL, Embase, OT-Seeker) were searched for non-randomised and randomised controlled trials that evaluated home modifications recommended by an occupational therapist. Two authors screened abstracts for inclusion and study quality was evaluated using the PEDro scale.


13 studies were included in this review with an average PEDro score of 6.1 (moderate quality). Effect sizes were calculated as standardised mean differences since difference outcome measures were used. Occupational therapy prescribed home modifications showed a moderate effect on the number of falls (RR 0.66; CI 95% 0.61,0.72) and minimal effect on quality of life (SMD -0.02; CI 95% -0.16,0.11), independence in self-care (SMD 0.90; CI 95% -0.27,2.06) and instrumental activities of daily living (SMD 0.97; CI 95% -0.10,2.04) at 12 months.

Significance of findings to Allied Health:

Occupational therapy home modifications can reduce falls but have minimal effect on other outcomes. The results from our study can be used by occupational therapists and allied health managers to guide resources towards home modifications for people who have had previous falls.