{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T03:01:10Z","timestamp":1793934070283,"version":"4.8.0"},"reference-count":25,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T00:00:00Z","timestamp":1750032000000},"content-version":"unspecified","delay-in-days":15,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Newcastle Patient Safety Research Collaboration"},{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,5,30]]},"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Patients with frailty are at risk of adverse outcomes such as mortality, falls, deconditioning and hospital readmissions. With an increasingly ageing population and a greater likelihood of frailty, there is a significant need to ensure that patients are managed in the right place and at the right time. There has been a focus on offering hospital-level care at home as a way to meet this need, incorporating strategies to integrate care and use digital solutions. Digital twin (DT) technology is one advancement, offering a virtual replica of an object\/environment, which has the potential to make use of real-time data personalised for an individual patient and\/or setting to inform and support patient management decisions. We are yet to realise the full potential of this new way of integrated working and technological advancements. This scoping review aims to ascertain the current evidence for the components of the DT architecture to enable the monitoring and management of patients with frailty living at home.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This scoping review will follow the Joanna Briggs Institute methodology for scoping reviews and will be reported following the Preferred Reporting Items for Systematic Reviews Extension for Scoping Reviews guidelines. The following electronic databases will be searched: Medline, Embase, CINAHL, Cochrane CENTRAL, Web of Science and Scopus. Relevant websites will be searched for grey literature or case reports to capture the required information, as well as any documents provided by stakeholders. Primary studies, published in the English language from 2019 to the present day, which report on the monitoring or management of patients with long-term conditions and frailty within their home environment, will be included. Screening will be conducted by at least two independent reviewers against eligibility criteria, and a piloted data extraction form will be used to align with the research questions. Qualitative content analysis will be used. Data will be presented in tabular form, as well as descriptive and illustrative formats, to address the objectives of this review.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Ethics and dissemination<\/jats:title>\n                  <jats:p>This scoping review does not require ethical approval. The findings of this review will be disseminated through peer-reviewed journals and conferences and will support the development of a conceptual model of a hospital-at-home DT for the management of patients with frailty.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-093418","type":"journal-article","created":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T06:20:24Z","timestamp":1750141224000},"page":"e093418","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Hospital at home digital twin for the management of patients with frailty: a scoping review protocol"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9438-353X","authenticated-orcid":false,"given":"Faiza","family":"Yahya","sequence":"first","affiliation":[{"name":"Newcastle Patient Safety Research Collaboration, Newcastle University, Newcastle upon Tyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5915-2429","authenticated-orcid":false,"given":"Matthew","family":"Cooper","sequence":"additional","affiliation":[{"name":"Newcastle Patient Safety Research Collaboration, Newcastle University, Newcastle upon Tyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamad","family":"Kassem","sequence":"additional","affiliation":[{"name":"School of Engineering, Newcastle University, Newcastle upon Tyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3168-5386","authenticated-orcid":false,"given":"Hamde","family":"Nazar","sequence":"additional","affiliation":[{"name":"Newcastle Patient Safety Research Collaboration, Newcastle University, Newcastle upon Tyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,6,17]]},"reference":[{"key":"2025071022165274000_15.6.e093418.1","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-018-38072-7","article-title":"The role of frailty in predicting mortality and readmission in older adults in acute care wards: a prospective study","volume":"9","author":"Hao","year":"2019","journal-title":"Sci Rep"},{"key":"2025071022165274000_15.6.e093418.2","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/56.3.M146"},{"key":"2025071022165274000_15.6.e093418.3","doi-asserted-by":"crossref","first-page":"1376","DOI":"10.1016\/S0140-6736(19)31785-4","article-title":"Management of frailty: opportunities, challenges, and future directions","volume":"394","author":"Dent","year":"2019","journal-title":"The Lancet"},{"key":"2025071022165274000_15.6.e093418.4","doi-asserted-by":"crossref","first-page":"e323","DOI":"10.1016\/S2468-2667(18)30091-4","article-title":"Frailty and pre-frailty in middle-aged and older adults and its association with multimorbidity and mortality: a prospective analysis of 493 737 UK Biobank participants","volume":"3","author":"Hanlon","year":"2018","journal-title":"Lancet Public Health"},{"key":"2025071022165274000_15.6.e093418.5","doi-asserted-by":"publisher","DOI":"10.1001\/.418"},{"key":"2025071022165274000_15.6.e093418.6","unstructured":"British Geriatric Society . Introduction to frailty, fit for frailty part 1. 2014. Available: https:\/\/www.bgs.org.uk\/resources\/introduction-to-frailty [Accessed 06 Jul 2024]."},{"key":"2025071022165274000_15.6.e093418.7","unstructured":"British Geriatric Society . Frailty: what\u2019s it all about? 2018. Available: https:\/\/www.bgs.org.uk\/resources\/frailty-what%E2%80%99s-it-all-about [Accessed 06 Jul 2024]."},{"key":"2025071022165274000_15.6.e093418.8","doi-asserted-by":"publisher","DOI":"10.3310\/hta21410"},{"key":"2025071022165274000_15.6.e093418.9","doi-asserted-by":"crossref","DOI":"10.3389\/fpsyt.2021.736804","article-title":"Socio-Demographic, Clinical and Psychological Profile of Frailty Patients Living in the Home Environment and Nursing Homes: A Cross-Sectional Study","volume":"12","author":"Muszalik","year":"2021","journal-title":"Front Psychiatry"},{"key":"2025071022165274000_15.6.e093418.10","unstructured":"Hospital at Home Society . What is hospital at home? 2023. Available: https:\/\/www.hospitalathome.org.uk\/whatis [Accessed 28 Nov 2023]."},{"key":"2025071022165274000_15.6.e093418.11","doi-asserted-by":"crossref","DOI":"10.1093\/ageing\/afae039","article-title":"Virtual wards for people with frailty: what works, for whom, how and why-a rapid realist review","volume":"53","author":"Westby","year":"2024","journal-title":"Age Ageing"},{"key":"2025071022165274000_15.6.e093418.12","doi-asserted-by":"crossref","unstructured":"Westby M , Ijaz S , Savovi\u0107 J , et al . Rapid realist review of virtual wards for people with frailty. Geriatric Medicine [Preprint]. doi:10.1101\/2023.04.18.23288729","DOI":"10.1101\/2023.04.18.23288729"},{"key":"2025071022165274000_15.6.e093418.13","doi-asserted-by":"crossref","DOI":"10.1093\/ageing\/afac319","article-title":"Virtual wards: a rapid evidence synthesis and implications for the care of older people","volume":"52","author":"Norman","year":"2023","journal-title":"Age Ageing"},{"key":"2025071022165274000_15.6.e093418.14","unstructured":"Hakim R . Realising the potential of virtual wards. 2023. Available: https:\/\/www.nhsconfed.org\/publications\/realising-potential-virtual-wards [Accessed 27 Aug 2024]."},{"key":"2025071022165274000_15.6.e093418.15","doi-asserted-by":"crossref","unstructured":"Dhanaraj RK , Murugesan S , Balusamy B , et al . Digital twin technologies for healthcare 4.0. 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