Effect of advance care planning on knowledge, behaviour, and well- being of older adults: a systematic review

We conducted a systematic review on the effect of advance care planning (ACP) on older adults in terms of (1) knowledge (of end-oflife care, treatment choices, and advanced directive [AD]), (2) behaviour (identification of the goal of care, utilisation of health services, and completion of AD), and (3) psychological well-being (levels of stress and depression, care satisfaction, and quality of life). Major databases for Chinese and English studies were searched; 6 randomised controlled trials were included for methodological quality assessment and metaanalysis. The overall effectiveness of ACP in older adults was limited because of insufficient outcome data for analysis. The evidence only shows that ACP increases the likelihood of older adults to opt for comfort care in the end of life. The effect of ACP on knowledge about end-of-life care issues and psychological well-being among older adults remains uncertain.