. 2014 Dec 1;14(19):1–72.

Table 3:

Description of Interventions and Outcomes

Author, Year	Interventions	Comparisons	Outcomes of Interest
Randomized controlled trials (RCTs)
Kirchhoff et al, 2012; (40) Kirchhoff et al, 2010 (41)	Tool: facilitation tool Type: single-provider; nurse, social worker, or chaplain who was trained to deliver the intervention Duration: 1.0–1.5 hours Frequency: NA Topics: patient and surrogate understanding, information about treatment, assistance with documentation of care preferences, surrogate understanding of patient preferences, preparing surrogate to make decisions that honour patient preferences; completion of STP	Usual care: standard AD counseling, assessment of AD on admission, question whether patient wanted more information, referrals according to institutional protocol	Concordance between patient wishes and care received Concordance between patient's and surrogate's wishes
Au et al, 2012 (42)	Tool: automated form Type: single-provider; physician Duration: NA Frequency: NA Topics: barriers and facilitators to EoL communication, patient preferences	Usual care^a	Completion of ACP documents and processes
Sampson et al, 2011 (51)	Tool: framework Type: single-provider; nurse Duration: NA Frequency: up to 4 consultations at least 5 days apart Topics: knowledge; illness severity and prognosis; patient's physical needs; social situation and social support; previous care preferences; cultural, spiritual, health, social, financial needs; role of palliative care; ACP Other: included a needs assessment, discussion with carers and family, summary of discussion in a standard form	Usual care^a	Informal caregiver's QoL Carer and family's satisfaction with care
Detering et al, 2010 (39)	Tool: Respecting Patient Choices model Type: single-provider; nurse who was trained to deliver the intervention; a physician was sometimes included Duration: Median length of discussion was 60 minutes (range 10–200 minutes) Frequency: NA Topics: prognosis, goals, values, beliefs, discuss and document choices for future health care, ACP Other: offered on top of usual care	Usual care: no ACP unless specifically requested	Patient's satisfaction with care Informal caregiver's and family's satisfaction with care Completion of ACP documents and processes
Gade et al, 2008 (43)	Tool: Weismann's palliative care components Type: team-based; physician, nurse, social worker, and chaplain Duration: NA Frequency: NA Topics: symptom management, psychosocial and spiritual support, EoL planning, posthospital care, diagnosis, prognosis, goals of care, ACP	Usual care^a	Patient's QoL Patient's satisfaction with care Completion of ACP documents and processes Hospital LOS
Clayton et al, 2007 (44)	Tool: question prompt list with 112 potential questions that was reviewed 20–30 minutes before the consultation Type: single-provider; physician Duration: NA Frequency: NA Topics: palliative care, physical symptoms, treatment, lifestyle and QoL, prognosis, support, EoL issues	Usual care: routine consultation	Patient's satisfaction with care
Lautrette et al, 2007 (45)	Tool: VALUE mnemonic, a brochure, and detailed procedures Type: team-based; physician and other professionals Duration: Median length of discussion was 30 minutes (range 19–45 minutes) Frequency: NA Topics: NA	Usual care: EoL family conference	ICU LOS
Gilmer et al, 2005 (46)	Tool: process model Type: team-based; ethicist consultant and other professionals Duration: NA Frequency: NA Topics: ethical issues, hospital policy, ethical consensus statements, statutes, laws, measures to improve communication, medical factors, patient preferences and values, QoL, context	Usual care: no ethics consultation was offered	Hospital LOS ICU LOS
Casarett et al, 2005 (48)	Tool: structured interview questionnaire Type: single-provider; physician Duration: NA Frequency: NA Topics: goals of care, life-sustaining treatment, symptoms, palliative care needs (i.e., comfort care, nursing support, practical support, ACP, emotional support, bereavement support, spiritual support, address loneliness)	Usual care: assessment by research assistant	Family's satisfaction with care Hospital care Hospital LOS
Song et al, 2005 (49)	Tool: Representational Approach model Type: single-provider; nurse Duration: NA Frequency: NA Topics: ACP, illness experiences, misconceptions and concerns, informed choices about medical care, treatment, complications, benefits Other: offered in addition to usual care	Usual care: information cards and a booklet if more information was desired	Concordance between patient's and surrogate's wishes
Nicolasora et al, 2006 (47)	Tools: script that provides detailed information about life-sustaining treatments and ADs Type: single-provider; physician Duration: NA Frequency: NA Topics: completion of ACP, CPR status, patient wishes for change, AD creation	Usual care: not approached by physician	Completion of ACP documents and processes
Dyar et al, 2012 (50)	Tool: none Type: single-provider; nurse practitioner Duration: NA Frequency: NA Topics: Five Wishes (a living will), information about hospices, needs assessment	Usual care^a	Patient's QoL
Jones et al, 2011 (52)	Tool: none Type: single-provider; nurse or physician who was trained to deliver the intervention Duration: NA Frequency: NA Topics: patient perceptions, communication with providers and family, hopes and fears for future, health care decision-making Other: family members were not invited to the first consultation, but they were included in subsequent sessions	Usual care^a	Patient's satisfaction with care
Observational with contemporaneous controls
Evangelista et al, 2012 (54)	Tool: none Type: single-provider; nurse or physician Duration: 50–120 minutes Frequency: NA Topics: patient's values, goals, preferences; areas where patient perceived the need for support (e.g., physical, symptom control, emotional support, illness understanding, treatment goals, ACP); establish treatment plan	Usual care: no palliative care consultation	Patient's QoL
Jacobsen et al, 2011 (55)	Tool: cognitive model for ACP Type: single-provider; physician, nurse, or social worker Duration: NA Frequency: NA Topics: information sharing ACP meetings, understanding, values, goals, preferences, selection of surrogate, prognosis, hopes, worries, CPR, place of death	Usual care^a	Completion of ACP documents and processes
Engelhardt et al, 2009 (56)	Tool: checklist Type: single-provider; social worker or health educator Duration: NA Frequency: took place over 6 sessions Topics: understanding, treatment, symptoms, prognosis, communication with providers, ACP, coping, existential issues, caregiving concerns, long-term care planning, home environmental modifications, etc. Other: in-person discussion followed by phone contact	Usual care^a	Patient's QoL Completion of ACP documents and processes Hospital care Emergency department visits Home health visits Outpatient services
Rabow et al, 2004 (57)	Tool: none Type: team-based; social worker, nurse, chaplain, pharmacist, psychologist, art therapist, volunteer coordinator, and 3 physicians Duration: NA Frequency: took place over 3 sessions Topics: NA Other: provided in addition to usual care	Usual care^a	Patient's QoL Patient's satisfaction with care Completion of ACP documents and processes Hospital care Hospital LOS Emergency department visits Urgent care visits Outpatient services
Mack et al, 2012 (58)	Tool: none Type: single-provider; 40% of discussions included a physician Duration: NA Frequency: NA Topics: ACP (i.e., do not resuscitate, hospices, palliative care, or not otherwise specified), venue of dying	No discussion^a	Chemotherapy Hospital care ICU admission Hospice care
Mack et al, 2010 (59)^a	Tool: none (assumed) Type: single-provider (assumed) Duration: NA Frequency: NA Topics: NA	No discussion^a	Concordance between patient's wishes and care received Hospice care
Wright et al, 2008 (60)^a	Tool: none (assumed) Type: single-provider (assumed) Duration: NA Frequency: NA Topics: NA	No discussion^a	Chemotherapy Hospice care
Casarett et al, 2008 (61)	Palliative care consultation Tool: none Type: team-based; physician, nurse practitioner, or both; social worker; nurse; chaplain; volunteers; and other professionals as needed Duration: NA Frequency: NA Topics: NA	Usual care^a	Patient's QoL
Morrison et al, 2005 (62)	Tool: aid to structure discussions Type: single-provider; social worker trained to deliver intervention Duration: NA Frequency: NA Topics: patient's decisional capacity, information on how to appoint proxies, communication with proxies, ACP, goals of care, feedback to physicians on congruence	Usual care^a	Concordance between patient's wishes and care received
Zhang et al, 2009 (53)^a	Tool: none (assumed) Type: single-provider; physician Duration: NA Frequency: NA Topics: preferences^a	No discussion^a	Patient's satisfaction Chemotherapy Resuscitation ICU admission Hospice care
Briggs et al, 2004 (63)	Tool: aid to structure discussions Type: single-provider; nurse, chaplain, or social worker who was trained to deliver the intervention Duration: 1 hour Frequency: NA Topics: patient and surrogate understanding, information about treatment, assistance with ACP documentation, surrogate's understanding of patient's preferences, preparing surrogate to make decisions that honour patient preferences, complete STP	Usual care: ACP literature, referral to trained ACP facilitator	Concordance between patient's and surrogate's wishes
Observational with historical controls
Lamba et al, 2012 (64)	Tool: none Type: team-based; Part I (physician and nurse), Part II (physician, nurse, counsellor, and interfaith pastor) Duration: NA Frequency: NA Topics: Part I (prognosis, ADs, family support, surrogate decision-maker, pain, other symptoms), Part II (likely patient outcomes; treatment options; goals of care; assessment of content on goals of care discussion, family understanding, issues of conflict)	Usual care^a	Completion of ACP documents and processes Hospital LOS ICU LOS
Norton et al, 2007 (65)	Tool: none Type: team-based; nurse practitioner, physician, chaplain, music therapist, massage therapist, and psychologist Duration: NA Frequency: NA Topics: medical history and physical exam, palliative care, involvement with team and family, other providers	Usual care: physician makes a palliative care referral	Hospital LOS ICU LOS
Lindner et al, 2007 (66)	Tool: electronic medical record note Type: single-provider; physician Duration: NA Frequency: NA Topics: information about surrogates, dates and content of prior written ADs, values, preferences, goals of care, wishes regarding resuscitation, artificial nutrition, hydration, hospital transfer, autopsy	Usual care^a	Concordance between patient's wishes and care received Completion of ACP documents and processes
Cross-sectional
Leung et al, 2012 (67)^a	Tool: none (assumed) Type: single-provider; physician Duration: NA Frequency: NA Topics: care planning^a	No discussion^a	Patient's satisfaction with care
Mori et al, 2013 (68)^a	Tool: none (assumed) Type: single-provider; health care provider Duration: NA Frequency: NA Topics: NA	No discussion^a	Family's satisfaction with care
Heyland et al, 2009 (11)^a	Tool: none (assumed) Type: single-provider; health care provider Duration: NA Frequency: NA Topics: NA	No discussion^a	Patient's satisfaction with care Family's satisfaction with care

Abbreviations: ACP, advance care planning; AD, advance directive; CPR, cardiopulmonary resuscitation; EoL, end of life; ICU, intensive care unit; LOS, length of stay; NA, not available; QoL, quality of life; RCT, randomized controlled trial; STP, statement of treatment preferences; VALUE, value comments made by the family, acknowledge family emotions, listen, understand the patient as a person, elicit family questions.

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