Advance Care Planning Shared Decision-Making Tools for Non-Cancer Chronic Serious Illness: A Mixed Method Systematic...

Area of Science:

• Palliative Care
• Ambulatory Care
• Shared Decision-Making

Background:

• Shared decision-making (SDM) tools aid advance care planning (ACP) and goals of care (GOC) conversations in serious non-cancer illnesses.
• Integrating SDM tools into ambulatory care can better support clinicians and patients/caregivers.

Purpose of the Study:

• Evaluate the effectiveness and implementation of integrating palliative care SDM tools into U.S. ambulatory care.
• Focus on adults with serious, life-threatening illnesses and their caregivers.

Main Methods:

• Systematic search of PubMed, CINAHL, and Cochrane Central Register (2000-2020).
• Included quantitative controlled, qualitative, and mixed-methods studies.
• Two reviewers screened articles, abstracted data, and assessed study quality/risk of bias.

Main Results:

• Included 6 RCTs and 5 qualitative studies in primary and specialty care.
• SDM tools focused on GOC communication or ACP.
• Palliative care SDM tools may improve patient satisfaction with communication and advance directive documentation.

Conclusions:

• ACP SDM tools show potential benefits for non-cancer serious illness.
• Further trials needed to assess concordance with care received and healthcare utilization.
• Integrating palliative care SDM tools in ambulatory settings may improve patient satisfaction and ACP documentation.