Mobile Applications for Advance Care Planning: A Comprehensive Review of Features, Quality, Content, and Readability

Mobile applications that facilitate each stage of the advance care planning process (i.e., obtaining knowledge, contemplating options, and acting on decisions) may be one effective way to support patient-centered care and patient autonomy. The purpose of the current review was to identify and evaluate advance care planning mobile applications for patients. Our specific aim was to examine app features, design quality, content, and readability. We searched the Apple iOS and Google Play stores using keywords developed in conjunction with an academic librarian. Two coders with expertise in palliative care applied guidelines from a previous review and used a consensus coding procedure. We also calculated a Flesh Reading Ease score for each app. Nine apps met criteria and could be evaluated. Overall, apps are limited in features and poor in terms of design quality, layout, and functionality. Regarding content, most apps emphasize making decisions or taking action about advance care planning: 6 apps permit users to document a preferred decision maker, and 6 apps offer a mechanism to distribute and share advance care planning documentation. Three apps focus on knowledge about advance care planning, and only 4 support contemplation about advance care planning. Apps range in terms of readability, from very difficult to fairly easy. This review identifies limitations in features, design quality, and content of existing advance care planning mobile apps. We present recommendations based on the results of this review for the development of future advance care planning apps.