The Effect of Advance Care Planning Intervention on Hospitalization Among Nursing Home Residents: A Systematic Review and Meta-Analysis

Apiradee Pimsen, Chi Yin Kao, Sheng Tzu Hsu, Bih Ching Shu

研究成果: Review article同行評審

10 引文 斯高帕斯(Scopus)

摘要

Objective: To evaluate the effect of advance care planning (ACP) interventions on the hospitalization of nursing home residents. Design: Systematic review and meta-analysis. Setting and Participants: Nursing homes and nursing home residents. Methods: A literature search was systematically conducted in 6 electronic databases (Embase, Ovid MEDLINE, Cochrane Library, CINAHL, AgeLine, and the Psychology & Behavioral Sciences Collection), in addition to hand searches and reference list checking; the articles retrieved were those published from 1990 to November 2021. The eligible studies were randomized controlled trials, controlled trials, and pre-post intervention studies describing original data on the effect of ACP on hospitalization of nursing home residents; these studies had to be written in English. Two independent reviewers appraised the quality of the studies and extracted the relevant data using the Joanna Briggs Institute abstraction form and critical appraisal tools. A study protocol was registered in PROSPERO (CRD42022301648). Results: The initial search yielded 744 studies. Nine studies involving a total of 57,180 residents were included in the review. The findings showed that the ACP reduced the likelihood of hospitalization [relative risk (RR) 0.54, 95% CI 0.47-0.63; I2 = 0%)], it had no effect on emergency department (ED) visits (RR 0.60, 95% CI 0.31-1.42; I2 = 99), hospice enrollment (RR 0.98, 95% CI 0.88-1.10; I2 = 0%), mortality (RR 0.83, 95% CI 0.68-1.00; I2 = 4%), and satisfaction with care (standardized mean difference: −0.04, 95% CI −0.14 to −0.06; I2 = 0%). Conclusion and Implications: ACP reduced hospitalizations but did not affect the secondary outcomes, namely, ED visits, hospice enrollment, mortality, and satisfaction with care. These findings suggest that policy makers should support the implementation of ACP programs in nursing homes. More robust studies are needed to determine the effects of ACP on ED visits, hospice enrollment, mortality, and satisfaction with care.

原文English
頁(從 - 到)1448-1460.e1
期刊Journal of the American Medical Directors Association
23
發行號9
DOIs
出版狀態Published - 2022 9月

All Science Journal Classification (ASJC) codes

  • 一般護理
  • 健康政策
  • 老年病學和老年學

指紋

深入研究「The Effect of Advance Care Planning Intervention on Hospitalization Among Nursing Home Residents: A Systematic Review and Meta-Analysis」主題。共同形成了獨特的指紋。

引用此