Implementing allied healthcare professionals in transitional care for older adults with mental health needs: A scoping review

Marina Motsenok; Ella C.N. Wong; Rozhannaa Sothilingam; Monica Antunes; Catherine Devion; Emma Wilson; Amanda Knoepfli; Emma Elliot; Tracey DasGupta; Naomi Ziegler; Sander L. Hitzig

doi:10.1371/journal.pone.0346032

Peer Review History

Original SubmissionOctober 15, 2025
26 Dec 2025 Decision Letter - Dragan Hrncic, Editor Dear Dr. Motsenok, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. ============================== ACADEMIC EDITOR: -->-->- please do follow the suggestions of our reviewers and improve the study presentation ============================== Please submit your revised manuscript by Feb 09 2026 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org . When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.. 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Kind regards, Prof. Dr. Dragan Hrncic, MD, PhD Academic Editor PLOS One Journal Requirements: If the reviewer comments include a recommendation to cite specific previously published works, please review and evaluate these publications to determine whether they are relevant and should be cited. There is no requirement to cite these works unless the editor has indicated otherwise. [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? Reviewer #1: Yes ******** 2. Has the statistical analysis been performed appropriately and rigorously? -->?> Reviewer #1: Yes ****** 3. Have the authors made all data underlying the findings in their manuscript fully available??> The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.--> Reviewer #1: Yes ****** 4. Is the manuscript presented in an intelligible fashion and written in standard English??> Reviewer #1: Yes ****** Reviewer #1: Major Issues: Clarity and Consistency in Terminology: The manuscript occasionally lacks consistency in the terminology used to describe key concepts, such as "transitional care" and "mental health needs." It is recommended to standardize the terminology throughout the manuscript, particularly in the introduction and methods sections, to avoid potential confusion among readers. Methodology and Data Analysis: While the study adheres to the PRISMA-ScR guidelines, the selection process for articles could benefit from more detail. Specifically, the rationale for excluding review articles and studies focused on conditions outside the scope of dementia (such as stroke or autism) could be better articulated. Furthermore, while thematic analysis is mentioned, a more detailed explanation of how the themes were derived and validated would strengthen the reliability of the results. Clarifying the process of data synthesis could also add transparency to the methodology. Depth of Discussion: The discussion of the results is relatively superficial in places. While it addresses the roles and challenges faced by allied healthcare professionals (AHC) in transitional care, a deeper exploration of how these roles specifically influence patient outcomes and the potential for improvement in care coordination would be valuable. Furthermore, the limitations of the studies included in the review, such as the small sample sizes and short follow-up periods, should be discussed in greater depth to provide a more balanced view of the evidence. Minor Issues: Literature Review and Background: The literature review could benefit from a more structured presentation. While the article references various studies, the connections between the studies and the research questions are not always clear. A clearer link between the review of literature and the gaps identified in the current research would help frame the need for this scoping review. Inclusion Criteria: The inclusion criteria (published from 2010 to June 2025) are clearly stated; however, a clearer explanation of the exclusion criteria (e.g., the decision to exclude studies on non-dementia neurological conditions) would help improve the reproducibility of the search process. Statistical Reporting: Although the manuscript includes mixed-methods studies, more detailed statistical reporting of the quantitative studies, especially the effect sizes or statistical significance of key findings, would help enhance the robustness of the conclusions. For example, reporting p-values or confidence intervals for key findings related to hospital readmission rates would be beneficial. ****** what does this mean? ). If published, this will include your full peer review and any attached files.). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our For information about this choice, including consent withdrawal, please see our Privacy Policy .--> Reviewer #1: Yes: SALMAN ASHFAQ AHMADSALMAN ASHFAQ AHMAD ******** [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] To ensure your figures meet our technical requirements, please review our figure guidelines: https://journals.plos.org/plosone/s/figures You may also use PLOS’s free figure tool, NAAS, to help you prepare publication quality figures: https://journals.plos.org/plosone/s/figures#loc-tools-for-figure-preparation. NAAS will assess whether your figures meet our technical requirements by comparing each figure against our figure specifications. https://doi.org/10.1371/journal.pone.0346032.r001
Revision 1
6 Feb 2026 Author Response Reviewer #1: Major Issues: 1. Clarity and Consistency in Terminology: The manuscript occasionally lacks consistency in the terminology used to describe key concepts, such as "transitional care" and "mental health needs." It is recommended to standardize the terminology throughout the manuscript, particularly in the introduction and methods sections, to avoid potential confusion among readers. We thank the reviewer for flagging this issue. We have standardized the terminology and added clear definitions for key concepts such as mental health conditions and mental health needs (lines 98-103). 2. Methodology and Data Analysis: While the study adheres to the PRISMA-ScR guidelines, the selection process for articles could benefit from more detail. Specifically, the rationale for excluding review articles and studies focused on conditions outside the scope of dementia (such as stroke or autism) could be better articulated. Furthermore, while thematic analysis is mentioned, a more detailed explanation of how the themes were derived and validated would strengthen the reliability of the results. Clarifying the process of data synthesis could also add transparency to the methodology. We appreciate these valuable suggestions. We added a clarification of our rationale in excluding review articles and stated that this was done to ensure that the scoping review mapped the findings of primary research, following the methodology of scoping reviews as described by Arksey and O’Malley (2005) (lines 195-196). Additionally, we explained why we chose to exclude neurodevelopmental or neurological conditions, as they are typically supported by acute, rehabilitative or developmental services rather than mental health care (lines 198-199). Finally, our data analysis section has been strengthened by a more detailed explanation of how the themes were derived and validated (lines 212-221). 3. Depth of Discussion: The discussion of the results is relatively superficial in places. While it addresses the roles and challenges faced by allied healthcare professionals (AHC) in transitional care, a deeper exploration of how these roles specifically influence patient outcomes and the potential for improvement in care coordination would be valuable. Furthermore, the limitations of the studies included in the review, such as the small sample sizes and short follow-up periods, should be discussed in greater depth to provide a more balanced view of the evidence. We thank the reviewer for raising these important points. In response, we strengthened the Discussion by providing a more in-depth examination of how allied health care roles influence patient outcomes and enhance care coordination (lines 388–392, 407–419). Although limitations of the reviewed literature, including small sample sizes and short follow-up periods, were noted in the Results section (lines 315–331), we agree that further consideration was warranted. We have therefore added a dedicated paragraph to the Limitations section to more fully describe the factors that constrain the strength and interpretation of the evidence (lines 447–457). Minor Issues: 4. Literature Review and Background: The literature review could benefit from a more structured presentation. While the article references various studies, the connections between the studies and the research questions are not always clear. A clearer link between the review of literature and the gaps identified in the current research would help frame the need for this scoping review. We thank the reviewer for this suggestion. The introduction section has been revised for clarity and to streamline the presentation of the literature and its connection to the research questions. 5. Inclusion Criteria: The inclusion criteria (published from 2010 to June 2025) are clearly stated; however, a clearer explanation of the exclusion criteria (e.g., the decision to exclude studies on non-dementia neurological conditions) would help improve the reproducibility of the search process. We have clarified our rationale for excluding review articles and non-dementia neurological conditions (lines 195-199). 6. Statistical Reporting: Although the manuscript includes mixed-methods studies, more detailed statistical reporting of the quantitative studies, especially the effect sizes or statistical significance of key findings, would help enhance the robustness of the conclusions. For example, reporting p-values or confidence intervals for key findings related to hospital readmission rates would be beneficial. We thank the reviewer for this helpful suggestion. Statistical results have been added to Table 1 (Characteristics of included studies) when specific key findings were reported (as opposed to a summary of overall results or conclusions). https://doi.org/10.1371/journal.pone.0346032.r002
16 Mar 2026 Decision Letter - Dragan Hrncic, Editor Implementing allied healthcare professionals in transitional care for older adults with mental health needs: a scoping review PONE-D-25-55037R1 Dear Dr. Motsenok, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice will be generated when your article is formally accepted. Please note, if your institution has a publishing partnership with PLOS and your article meets the relevant criteria, all or part of your publication costs will be covered. Please make sure your user information is up-to-date by logging into Editorial Manager at Editorial Manager® and clicking the ‘Update My Information' link at the top of the page. For questions related to billing, please contact and clicking the ‘Update My Information' link at the top of the page. For questions related to billing, please contact billing support .. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Prof. Dr. Dragan Hrncic, MD, PhD Academic Editor PLOS One Additional Editor Comments (optional): Reviewers' comments: Reviewer's Responses to Questions Comments to the Author Reviewer #1: All comments have been addressed ******** 2. Is the manuscript technically sound, and do the data support the conclusions??> Reviewer #1: Yes ****** 3. Has the statistical analysis been performed appropriately and rigorously? -->?> Reviewer #1: Yes ****** 4. Have the authors made all data underlying the findings in their manuscript fully available??> The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.--> Reviewer #1: Yes ****** 5. Is the manuscript presented in an intelligible fashion and written in standard English??> Reviewer #1: Yes ****** Reviewer #1: Thank you for revising the manuscript and addressing the reviewer comments. I have carefully examined the revised version along with the authors’ responses to the previous review. The authors have adequately addressed the concerns raised during the earlier round of review, and the revisions have improved the clarity and quality of the manuscript. The responses provided are satisfactory, and the manuscript is acceptable in its current form. ****** what does this mean? ). If published, this will include your full peer review and any attached files.). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our For information about this choice, including consent withdrawal, please see our Privacy Policy .--> Reviewer #1: Yes: Salman Ashfaq AhmadSalman Ashfaq Ahmad ******** https://doi.org/10.1371/journal.pone.0346032.r003
Formally Accepted
Acceptance Letter - Dragan Hrncic, Editor PONE-D-25-55037R1 PLOS One Dear Dr. Motsenok, I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS One. Congratulations! Your manuscript is now being handed over to our production team. At this stage, our production department will prepare your paper for publication. This includes ensuring the following: * All references, tables, and figures are properly cited * All relevant supporting information is included in the manuscript submission, * There are no issues that prevent the paper from being properly typeset You will receive further instructions from the production team, including instructions on how to review your proof when it is ready. Please keep in mind that we are working through a large volume of accepted articles, so please give us a few days to review your paper and let you know the next and final steps. Lastly, if your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. You will receive an invoice from PLOS for your publication fee after your manuscript has reached the completed accept phase. If you receive an email requesting payment before acceptance or for any other service, this may be a phishing scheme. Learn how to identify phishing emails and protect your accounts at https://explore.plos.org/phishing. If we can help with anything else, please email us at customercare@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Professor Dragan Hrncic Academic Editor PLOS One https://doi.org/10.1371/journal.pone.0346032.r004

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