Effectiveness of Nurse Led Advance Care Planning Intervention for Chronic Respiratory Diseases: A Meta-Analysis

Chronic respiratory diseases present significant challenges for healthcare management, necessitating effective communication and planning for future care. Nurse-led advance care planning (ACP) interventions aim to improve patient outcomes by facilitating discussions about care preferences and treatment choices. This meta-analysis evaluates the effectiveness of nurse-led ACP interventions on various outcomes in patients with chronic respiratory diseases.

Comprehensive search was conducted across PubMed, Embase, Cochrane Central Register of Controlled Trials, Scopus, Web of Science, and Google Scholar up to May 2024. Randomised controlled trials and non-randomised trials assessing the impact of nurse-led ACP interventions were included. Pooled standardised mean differences (SMD) and odds ratios (OR) were calculated using a random-effects model, with heterogeneity assessed via I² and τ² statistics.

For quality of life, pooled SMD was 0.073 (95% CI: -0.372 to 0.517), indicating negligible effect. Quality of communication showed pooled SMD of 2.137 (95% CI: -0.343 to 4.616). Anxiety had pooled SMD of -0.166 (95% CI: -0.628 to 0.296). Depression scores increased slightly (SMD = 0.756; 95% CI: -0.987 to 2.499). Hospital admissions (SMD = 0.127; 95% CI: -0.085 to 0.338) and length of hospital stay (SMD = 0.145; 95% CI: -0.091 to 0.382) both showed minimal effects with low heterogeneity. Discussions with physicians about treatment choices had OR of 1.773 (95% CI: 0.899 to 3.497), indicating positive but nonsignificant increase. Completion of advanced directives showed OR of 1.856 (95% CI: 0.999-3.488).

Nurse-led ACP interventions have a significant impact on the quality of communication between patients and healthcare providers, though their effect on the quality of life and other clinical outcomes is less pronounced.