Advance Care Planning in Patients With Stroke: A Scoping Review

This scoping review sought to provide an overview and characterization of the present state and experimental studies related to advance care planning (ACP) in patients with stroke. A comprehensive literature search was performed across four databases-PubMed, CINAHL Plus, MEDLINE, and Web of Science-for articles published through January 31, 2024. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) statement was used to report this scoping review. The main search terms were "advance care planning" and "stroke" and the narrative synthesis method was used. Eleven studies met the inclusion criteria. Six studies reported ACP discussion and/or advance directive documentation rates. There was an intervention study and a study investigated a decision support tool which was specifically designed for patients with stroke. Studies on ACP in patients with stroke are limited and heterogeneous. Age and stroke-related knowledge were the two main factors associated with ACP completion rates. There are multiple obstacles in proxy decision-making and ACP discussion of patients with stroke.