Terapia ocupacional domiciliar digital: Estratégias inovadoras de telemonitoramento para promoção da autonomia funcional em pessoas idosas frágeis

Population ageing and frailty increase the demand for home care aimed at functional autonomy, and digital technologies offer new possibilities for Occupational Therapy. This study aimed to analyze the evidence published between 2021 and 2026 on digital telemonitoring and home intervention strategies to promote the functional autonomy of frail older adults or those with functional decline and, based on it, to propose a model of Digital Home Occupational Therapy. This is an integrative review, with a question structured by the PICO strategy, reporting guided by PRISMA 2020 and level of evidence according to Melnyk and Fineout-Overholt. Seventeen searches were run in an academic search engine and open-access portals in October 2026; of 159 records identified, 14 studies were included, eight of them randomized controlled trials, mostly pilots. Strategies were grouped into synchronous teleconsultation, asynchronous digital programs with remote follow-up, platforms with sensors and alerts, and telephone telemonitoring. Home monitoring with sensors reduced the risk of frailty worsening by 74% at six months; a mobile health platform reversed pre-frailty in two thirds of participants; occupational telerehabilitation after hip fracture improved instrumental activities of daily living; and exergame and video programs improved mobility, balance and fall efficacy. Adherence and satisfaction were high, and digital inclusion was the main barrier. Digital Occupational Therapy is promising and feasible, but profession-specific evidence remains scarce, which justifies the proposed model and multicenter trials.