State of advance care planning research : a descriptive overview of systematic reviews

Objective. To provide an overview of the current state of research of advance care planning (ACP), highlighting most studied topics, publication time, quality of studies and reported outcomes, and to identify gaps to improve ACP receptivity, utilization, implementation, and outcomes. Method. Coc...

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Main Authors: Jimenez, Geronimo, Tan, Woan Shin, Virk, Amrit K., Low, Chan Kee, Car, Josip, Ho, Andy Hau Yan
Other Authors: School of Social Sciences
Format: Article
Language:English
Published: 2019
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Online Access:https://hdl.handle.net/10356/82860
http://hdl.handle.net/10220/50291
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Institution: Nanyang Technological University
Language: English
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spelling sg-ntu-dr.10356-828602020-03-07T12:56:02Z State of advance care planning research : a descriptive overview of systematic reviews Jimenez, Geronimo Tan, Woan Shin Virk, Amrit K. Low, Chan Kee Car, Josip Ho, Andy Hau Yan School of Social Sciences Interdisciplinary Graduate School (IGS) Lee Kong Chian School of Medicine (LKCMedicine) Advance Care Planning Palliative Care Science::Medicine Objective. To provide an overview of the current state of research of advance care planning (ACP), highlighting most studied topics, publication time, quality of studies and reported outcomes, and to identify gaps to improve ACP receptivity, utilization, implementation, and outcomes. Method. Cochrane methodology for conducting overviews of systematic reviews. Study quality was assessed using a modified version of the Assessing the Methodological Quality of Systematic Reviews tool. The following databases were searched from inception to April 2017: MEDLINE, EBM Reviews, Cochrane Reviews, CINAHL, Global Health, PsycINFO, and EMBASE. Searches were supplemented with gray literature and manual searches. Result. Eighty systematic reviews, covering 1,662 single articles, show that ACP-related research focuses on nine main topics: (1) ACP as part of end-of-life or palliative care interventions, (2) care decision-making; (3) communication strategies; (4) factors influencing ACP implementation; (5) ACP for specific patient groups, (6) ACP effectiveness; (7) ACP experiences; (8) ACP cost; and (9) ACP outcome measures. The majority of this research was published since 2014, its quality ranges from moderate to low, and reports on documentation, concordance, preferences, and resource utilization outcomes. Significance of results. Despite the surge of ACP research, there are major knowledge gaps about ACP initiation, timeliness, optimal content, and impact because of the low quality and fragmentation of the available evidence. Research has mostly focused on discrete aspects within ACP instead of using a holistic evaluative approach that takes into account its intricate working mechanisms, the effects of systems and contexts, and the impacts on multilevel stakeholders. Higher quality studies and innovative interventions are needed to develop effective ACP programs and address research gaps. MOH (Min. of Health, S’pore) Accepted version 2019-10-30T08:58:32Z 2019-12-06T15:07:02Z 2019-10-30T08:58:32Z 2019-12-06T15:07:02Z 2019 Journal Article Jimenez, G., Tan, W. S., Virk, A. K., Low, C. K., Car, J., & Ho, A. H. Y. (2019). State of advance care planning research : a descriptive overview of systematic reviews. Palliative and Supportive Care, 17(2), 234-244. doi:10.1017/S1478951518000500 1478-9515 https://hdl.handle.net/10356/82860 http://hdl.handle.net/10220/50291 10.1017/S1478951518000500 en Palliative and Supportive Care © 2019 Cambridge University Press (CUP). All rights reserved. This paper was published in Palliative and Supportive Care and is made available with permission of Cambridge University Press (CUP). 39 p. application/pdf
institution Nanyang Technological University
building NTU Library
country Singapore
collection DR-NTU
language English
topic Advance Care Planning
Palliative Care
Science::Medicine
spellingShingle Advance Care Planning
Palliative Care
Science::Medicine
Jimenez, Geronimo
Tan, Woan Shin
Virk, Amrit K.
Low, Chan Kee
Car, Josip
Ho, Andy Hau Yan
State of advance care planning research : a descriptive overview of systematic reviews
description Objective. To provide an overview of the current state of research of advance care planning (ACP), highlighting most studied topics, publication time, quality of studies and reported outcomes, and to identify gaps to improve ACP receptivity, utilization, implementation, and outcomes. Method. Cochrane methodology for conducting overviews of systematic reviews. Study quality was assessed using a modified version of the Assessing the Methodological Quality of Systematic Reviews tool. The following databases were searched from inception to April 2017: MEDLINE, EBM Reviews, Cochrane Reviews, CINAHL, Global Health, PsycINFO, and EMBASE. Searches were supplemented with gray literature and manual searches. Result. Eighty systematic reviews, covering 1,662 single articles, show that ACP-related research focuses on nine main topics: (1) ACP as part of end-of-life or palliative care interventions, (2) care decision-making; (3) communication strategies; (4) factors influencing ACP implementation; (5) ACP for specific patient groups, (6) ACP effectiveness; (7) ACP experiences; (8) ACP cost; and (9) ACP outcome measures. The majority of this research was published since 2014, its quality ranges from moderate to low, and reports on documentation, concordance, preferences, and resource utilization outcomes. Significance of results. Despite the surge of ACP research, there are major knowledge gaps about ACP initiation, timeliness, optimal content, and impact because of the low quality and fragmentation of the available evidence. Research has mostly focused on discrete aspects within ACP instead of using a holistic evaluative approach that takes into account its intricate working mechanisms, the effects of systems and contexts, and the impacts on multilevel stakeholders. Higher quality studies and innovative interventions are needed to develop effective ACP programs and address research gaps.
author2 School of Social Sciences
author_facet School of Social Sciences
Jimenez, Geronimo
Tan, Woan Shin
Virk, Amrit K.
Low, Chan Kee
Car, Josip
Ho, Andy Hau Yan
format Article
author Jimenez, Geronimo
Tan, Woan Shin
Virk, Amrit K.
Low, Chan Kee
Car, Josip
Ho, Andy Hau Yan
author_sort Jimenez, Geronimo
title State of advance care planning research : a descriptive overview of systematic reviews
title_short State of advance care planning research : a descriptive overview of systematic reviews
title_full State of advance care planning research : a descriptive overview of systematic reviews
title_fullStr State of advance care planning research : a descriptive overview of systematic reviews
title_full_unstemmed State of advance care planning research : a descriptive overview of systematic reviews
title_sort state of advance care planning research : a descriptive overview of systematic reviews
publishDate 2019
url https://hdl.handle.net/10356/82860
http://hdl.handle.net/10220/50291
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