Understanding how, why and for whom occupational therapy works in primary care. A rapid realist review protocol for stakeholder consultation

This rapid realist review protocol has been designed to better understand how occupational therapists contribute within the primary care workforce. This protocol is version one and will be reviewed by our expert panel. Following panel discussion any amendments will be recorded in version 2.

Occupational therapy in primary care is a complex, context dependent practice whose effects depend on how mechanisms are triggered in specific organisational and population contexts (Duddy and Wong, 2022). Realist approaches are especially suited to the fluid, multifaceted healthcare environment (Jagosh et al., 2022). A rapid realist review (RRR) is designed to deliver theory informed evidence and is a pragmatic choice where there are resource limitations or literature is emerging (Saul et al., 2013), which is the case with occupational therapy in primary care. RRRs retain the core features of realist synthesis (development and iterative refinement of programme theory, attention to context–mechanism–outcome [CMO] configurations) while using focused questions, stakeholder guided searching and prioritisation of key sources to deliver findings within months (Saul et al., 2013; Tricco et al., 2015; Zibrowski et al., 2020). Given current workforce and primary care policy timelines, a RRR offers an appropriate balance between explanatory depth and timeliness. This rapid realist review also responds to research priorities identified by the RCOT (2024, 2025) and addresses wider uncertainty around the role of additional professions in primary care (Leary and Punshon, 2024).