Abstract
Purpose: Elderly heart failure (HF) patients are increasing, they have a significant symptom burden and palliative care needs including advance care planning (ACP). End-of-life discussion is needed to improve quality of life among elderly HF patients, little is known about factors related to promoting ACP and completion of advance directives (AD) in HF patients. This study examined completion rates of AD and predictors of ACP process in HF patients by conducting a systematic review.
Methods: We searched PubMed and CINAHL from 1992 to 21 June 2016 using keywords “congestive heart failure”, “heart failure”, “advance care planning”, “advance directives”, “completion”, “factors”, and “predictors”. Abstracts of the search results were reviewed according to inclusion criteria which refer to completion rates of AD and factors related to ACP process.
Results: Fourteen articles were selected according to the criteria. Participants were 6 inpatients, 3 outpatients, 1 community-dwelling persons, 1 family, and 4 physicians or providers. Completion rates of AD were from 12.7% to 49%. Factors related to completion of AD were older age, gender, race, marital status, education, perceived health, informed about ADs, knowledge, discussed AD with family, and discussed AD with physician.
Conclusion: AD Completion rates were not high in HF patients. Few patients were not ready to talk about ACP in outpatients, therefore, patient and provider discussion before is important to promote ACP and completion of AD in elderly HF patients.