scholarly journals Advance care planning: A systematic review of randomised controlled trials conducted with older adults

Maturitas ◽  
2016 ◽  
Vol 91 ◽  
pp. 101-109 ◽  
Author(s):  
Elizabeth Weathers ◽  
Rónán O’Caoimh ◽  
Nicola Cornally ◽  
Carol Fitzgerald ◽  
Tara Kearns ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Advance Care Planning ◽  
Randomised Controlled Trials ◽  
Controlled Trials ◽  
Care Planning ◽  
Advance Care ◽  
Randomised Controlled

scholarly journals The conceptual models and mechanisms of action that underpin advance care planning for cancer patients: A systematic review of randomised controlled trials

2018 ◽  
Vol 33 (1) ◽  
pp. 5-23 ◽  
Author(s):  
Cheng-Pei Lin ◽  
Catherine J Evans ◽  
Jonathan Koffman ◽  
Jo Armes ◽  
Fliss E M Murtagh ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cancer Patients ◽  
Advance Care Planning ◽  
Randomised Controlled Trials ◽  
Conceptual Models ◽  
Mechanisms Of Action ◽  
Controlled Trials ◽  
Care Planning ◽  
Advance Care ◽  
Randomised Controlled

Background: No systematic review has focused on conceptual models underpinning advance care planning for patients with advanced cancer, and the mechanisms of action in relation to the intended outcomes. Aim: To appraise conceptual models and develop a logic model of advance care planning for advanced cancer patients, examining the components, processes, theoretical underpinning, mechanisms of action and linkage with intended outcomes. Design: A systematic review of randomised controlled trials was conducted, and was prospectively registered on PROSPERO. Narrative synthesis was used for data analysis. Data sources: The data sources were MEDLINE, CINAHL, PsycINFO, EMBASE, CENTRAL, PROSPERO, CareSearch, and OpenGrey with reference chaining and hand-searching from inception to 31 March 2017, including all randomised controlled trials with advance care planning for cancer patients in the last 12 months of life. Cochrane quality assessment tool was used for quality appraisal. Results: Nine randomised controlled trials were included, with only four articulated conceptual models. Mechanisms through which advance care planning improved outcomes comprised (1) increasing patients’ knowledge of end-of-life care, (2) strengthening patients’ autonomous motivation, (3) building patients’ competence to undertake end-of-life discussions and (4) enhancing shared decision-making in a trustful relationship. Samples were largely highly educated Caucasian. Conclusion: The use of conceptual models underpinning the development of advance care planning is uncommon. When used, they identify the individual behavioural change. Strengthening patients’ motivation and competence in participating advance care planning discussions are key mechanisms of change. Understanding cultural feasibility of the logic model for different educational levels and ethnicities in non-Western countries should be a research priority.

scholarly journals Increasing engagement in advance care planning using a behaviour change model: study protocol for the STAMP randomised controlled trials

BMJ Open ◽  
2018 ◽  
Vol 8 (8) ◽  
pp. e025340 ◽  
Author(s):  
Terri R Fried ◽  
Colleen A Redding ◽  
Steven Martino ◽  
Andrea Paiva ◽  
Lynne Iannone ◽  
...  
Keyword(s):  
Usual Care ◽  
Behaviour Change ◽  
Advance Care Planning ◽  
Randomised Controlled Trials ◽  
Institutional Review Boards ◽  
Controlled Trials ◽  
Care Planning ◽  
Link Type ◽  
Advance Care ◽  
Randomised Controlled

IntroductionAdvance care planning (ACP) is a key component of high-quality end-of-life care but is underused. Interventions based on models of behaviour change may fill an important gap in available programmes to increase ACP engagement. Such interventions are designed for broad outreach and flexibility in delivery. The purpose of the Sharing and Talking about My Preferences study is to examine the efficacy of three behaviour change approaches to increasing ACP engagement through two related randomised controlled trials being conducted in different settings (Veterans Affairs (VA) medical centre and community).Methods and analysisEligible participants are 55 years or older. Participants in the community are being recruited in person in primary care and specialty outpatient practices and senior living sites, and participants in the VA are recruited by telephone. In the community, randomisation is at the level of the practice or site, with all persons at a given practice/site receiving either computer-tailored feedback with a behaviour stage-matched brochure (computer-tailored intervention (CTI)) or usual care. At the VA, randomisation is at the level of the participant and is stratified by the number of ACP behaviours completed at baseline. Participants are randomised to one of four groups: CTI, motivational interviewing, motivational enhancement therapy or usual care. The primary outcome is completion of four key ACP behaviours: identification of a surrogate decision maker, communication about goals, completing advance directives and ensuring documents are in the medical record. Analysis will be conducted using mixed effects models, taking into account the clustered randomisation for the community study.Ethics and randomisationThe studies have been approved by the appropriate Institutional Review Boards and are being overseen by a Safety Monitoring Committee. The results of these studies will be disseminated to academic audiences and leadership in in the community and VA sites.Trial registration numbersNCT03137459andNCT03103828.

Non-pharmacological interventions to improve constipation amongst older adults in long-term care settings: A systematic review of randomised controlled trials

2020 ◽  
Vol 41 (6) ◽  
pp. 992-999
Author(s):  
Iria Dobarrio-Sanz ◽  
José Manuel Hernández-Padilla ◽  
María Mar López-Rodríguez ◽  
Cayetano Fernández-Sola ◽  
José Granero-Molina ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Randomised Controlled Trials ◽  
Long Term Care ◽  
Controlled Trials ◽  
Pharmacological Interventions ◽  
Term Care ◽  
Randomised Controlled

Geriatric characteristics in randomised controlled trials on antidepressant drugs for older adults: a systematic review

2016 ◽  
Vol 31 (9) ◽  
pp. 990-1003 ◽  
Author(s):  
Carolien E. M. Benraad ◽  
Floor Kamerman-Celie ◽  
Barbara C. van Munster ◽  
Richard C. Oude Voshaar ◽  
Jan Spijker ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Randomised Controlled Trials ◽  
Antidepressant Drugs ◽  
Controlled Trials ◽  
Randomised Controlled

scholarly journals A systematic review of the impacts of intergenerational engagement on older adults’ cognitive, social, and health outcomes.

2021 ◽  
Author(s):  
Anna Krzeczkowska ◽  
David Spalding ◽  
William J. McGeown ◽  
Alan J. Gow ◽  
Michelle Carlson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Health Outcomes ◽  
Randomised Controlled Trials ◽  
Cognitive Outcomes ◽  
Controlled Trials ◽  
Ageing Population ◽  
High Quality Research ◽  
Age Attitudes ◽  
Randomised Controlled

Background: Promoting older adults’ health and wellbeing via intergenerational engagement can help with the needs of an ageing population. This systematic review evaluated the impacts of intergenerational engagement on cognitive, social, and health outcomes in healthy older adults and older adults with mild cognitive impairment. Research Design and Methods: Comprehensive literature searches were undertaken, with records screened and filtered according to pre-registered criteria. Study quality was formally assessed, and a narrative synthesis produced from the extracted findings.Results: Forty-four studies were included in the review. Two out of five studies found significant intergenerational engagement effects on cognitive outcomes; 16 of 24 on social outcomes; and 21 of 30 on health-related outcomes. Only 11 studies fully met the criteria for high quality research, of which the majority (eight) focused on social outcomes.Discussion and Implications: This review has identified potential benefits of intergenerational engagement, most notably regarding anxiety, generativity, cross-age attitudes, and physical activity. However, only five included studies were randomised, controlled trials, therefore strong conclusions cannot yet be drawn. More research is required involving gold standard and comparable models, enabling wider implementation and generalisability, and randomised, controlled trials to provide the highest quality evidence.

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