IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v67y2008i7p1122-1132.html
   My bibliography  Save this article

Assessing the effectiveness of interventions to promote advance directives among older adults: A systematic review and multi-level analysis

Author

Listed:
  • Bravo, Gina
  • Dubois, Marie-France
  • Wagneur, Bernard

Abstract

Many studies have investigated the effectiveness of interventions in promoting advance directives (ADs) but there is uncertainty as to what works best, and in whom. We conducted a systematic review of the evidence in this regard, using both classical meta-analysis approaches and multi-level analyses. Eleven databases were searched for relevant reports published through March 2007. All prospective studies were eligible, whether involving a single group or several and, in the latter case, regardless of the allocation mechanism. Outcomes included formal and informal ADs assessed by chart review or self-report. Heterogeneous sets of outcomes were pooled under a random-effects model. The search yielded 55 studies, half of which targeted outpatients. Most groups of subjects were educated in a single session led by one healthcare professional. Outcomes were measured within six months of the intervention in 73% of cases. The largest set of single-arm studies yielded an overall AD completion rate of 45.6%. Across randomized trials, the largest pooled odds ratio was 4.0, decreasing to 2.6 when all comparative studies were included. Multi-variable analyses identified the provision of oral information over multiple sessions as the most successful intervention. This was true regardless of the target population. These findings support the effectiveness of educational interventions in increasing the formulation of ADs and provide practical advice on how best to achieve this goal.

Suggested Citation

  • Bravo, Gina & Dubois, Marie-France & Wagneur, Bernard, 2008. "Assessing the effectiveness of interventions to promote advance directives among older adults: A systematic review and multi-level analysis," Social Science & Medicine, Elsevier, vol. 67(7), pages 1122-1132, October.
  • Handle: RePEc:eee:socmed:v:67:y:2008:i:7:p:1122-1132
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277-9536(08)00300-6
    Download Restriction: Full text for ScienceDirect subscribers only
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Rebecca Aslakson & Anne Schuster & Judith Miller & Matthew Weiss & Angelo Volandes & John Bridges, 2014. "An Environmental Scan of Advance Care Planning Decision Aids for Patients Undergoing Major Surgery: A Study Protocol," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 7(2), pages 207-217, June.
    2. Hu, Wen-Yu & Huang, Chien-Hsun & Chiu, Tai-Yuan & Hung, Shou-Hung & Peng, Jen-Kuei & Chen, Ching-Yu, 2010. "Factors that influence the participation of healthcare professionals in advance care planning for patients with terminal cancer: A nationwide survey in Taiwan," Social Science & Medicine, Elsevier, vol. 70(11), pages 1701-1704, June.
    3. Pollack, Keshia M. & Morhaim, Dan & Williams, Michael A., 2010. "The public's perspectives on advance directives: Implications for state legislative and regulatory policy," Health Policy, Elsevier, vol. 96(1), pages 57-63, June.
    4. Sheng‐Yu Fan & Huei‐Chuan Sung & Shu‐Chen Wang, 2019. "The experience of advance care planning discussion among older residents in a long‐term care institution: A qualitative study," Journal of Clinical Nursing, John Wiley & Sons, vol. 28(19-20), pages 3451-3458, October.
    5. Abigail Wickson-Griffiths & Sharon Kaasalainen & Jenny Ploeg & Carrie McAiney, 2014. "A Review of Advance Care Planning Programs in Long-Term Care Homes: Are They Dementia Friendly?," Nursing Research and Practice, Hindawi, vol. 2014, pages 1-11, March.
    6. Liz Crowe & Val Quinn & Lesley Chenoweth & Sanjeewa Kularatna & Jenny Boddy & Amanda J. Wheeler, 2015. "Advance Care Planning for Older Australians Living in the Community," SAGE Open, , vol. 5(2), pages 21582440155, June.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:67:y:2008:i:7:p:1122-1132. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no bibliographic references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.