Advance care planning: A systematic review of randomised controlled trials conducted with older adults

Autor: Alice Coffey, Elizabeth Weathers, Nicola Cornally, Edel Daly, Rónán O'Caoimh, Carol Fitzgerald, Ciara McGlade, Ronan O’Sullivan, D. William Molloy, Tara Kearns
Rok vydání: 2016
Předmět:
Advance care planning
health-care
medicine.medical_specialty
Palliative care
Health Services for the Aged
united-states
advance care directives
Psychological intervention
nursing-home residents
CINAHL
General Biochemistry
Genetics and Molecular Biology
directives
Advance Care Planning
03 medical and health sciences
0302 clinical medicine
systematic review
Nursing
Intervention (counseling)
Obstetrics and Gynaecology
Health care
end
medicine
Humans
030212 general & internal medicine
Young adult
older adults
intervention
cognitive impairment
Aged
Randomized Controlled Trials as Topic
palliative care
Biochemistry
Genetics and Molecular Biology(all)
business.industry
Obstetrics and Gynecology
of-life care
young-adults
030220 oncology & carcinogenesis
Scale (social sciences)
Family medicine
business
Zdroj: Maturitas. 91:101-109
ISSN: 0378-5122
DOI: 10.1016/j.maturitas.2016.06.016
Popis: Advance care planning (ACP), involving discussions between patients, families and healthcare professionals on future healthcare decisions, in advance of anticipated impairment in decision-making capacity, improves satisfaction and end-of-life care while respecting patient autonomy. It usually results in the creation of a written advanced care directive (ACD). This systematic review examines the impact of ACP on several outcomes (including symptom management, quality of care and healthcare utilisation) in older adults (>65years) across all healthcare settings. Nine randomised controlled trials (RCTs) were identified by searches of the CINAHL, PubMed and Cochrane databases. A total of 3646 older adults were included (range 72-88 years). Seven studies were conducted with community dwellers and the other two RCTs were conducted in nursing homes. Most studies did not implement a standardised ACD, or measure the impact on quality of end-of-life care or on the death and dying experience. All studies had some risk of bias, with most scoring poorly on the Oxford Quality Scale. While ACP interventions are well received by older adults and generally have positive effects on outcomes, this review highlights the need for well-designed RCTs that examine the economic impact of ACP and its effect on quality of care in nursing homes and other sectors.
Databáze: OpenAIRE
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