Rapid Review of existing evidence on Advance care Planning.
Although there is a significant body of literature informing the development and implementation of advance care planning processes, the impact of completed advance care plans on the decision making of healthcare professionals at the time of a medical event is less clear. Evidence for the impact of advance care planning programmes on the quality of care provided is required to underpin funding and delivery of integrated advance care planning across care settings. The purpose of this rapid review is to examine whether there is evidence that having an advance care plan in place assists healthcare professionals with care and medical intervention decisions at the time of a change in condition. The scope of the review is to assess for evidence for treatment decisions other than cardiopulmonary resuscitation which is a specific order often completed out with other advance care planning events.
A systematic search was conducted across a wide-ranging set of databases: Ovid Medline, including In-Process & Other Non-Indexed Citations, Ovid Embase, Ovid PsycINFO, EbscoCINAHL and Cochrane Library.
Overall the selected studies suggest that where a comprehensive programme of advance care planning is in place across care settings, those participants with orders to limit life sustaining treatments are less likely to receive interventions which are discrepant with their stated wishes. The evidence is strongest for intervention decisions taken in care home settings, with very limited evidence for acute care settings.
Dr Anthony Byrne
