Homecare services have become an important component of modern healthcare systems, including in tropical and resource-limited settings. However, the shift from hospital-based care to home-based care presents significant challenges related to patient safety. This systematic review aims to provide evidence related to effective findings in improving patient safety in homecare services with a focus on the role of caregivers, medication management, and the prevention of adverse events. A comprehensive Scopus search covering the period 2015–2025 yielded 41 eligible articles published between 2015 and 2024, which were synthesized following the PRISMA guidelines. The review revealed three main themes: the central role of patients and caregivers in creating safety; key operational domains of patient safety in home and outpatient settings; and innovative models and technologies to improve patient safety. Another key finding was the dominance of custom digital applications over standard analysis software indicating a shift toward practical user-centered solutions. Theoretical frameworks such as the Chronic Care Model, Complex Adaptive Systems, and Patient and Family Engagement Theory provided conceptual foundations for the reviewed interventions. The findings of this study underscore the importance of collaborative, adaptive, and contextual approaches in improving patient safety in homecare services, particularly in tropical regions.
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