2. Major intervention and comparator features.

STUDY ID	Agar 2017	Au 2012	Bernacki 2019	Clayton 2007	Epstein 2017	Lautrette 2007*	Reinhardt 2014	Walczak 2017
Intervention(s) aim and components	To improve EoL care   Facilitated CC + patient‐centred palliative care training	To improve communication about preferences for EoL care   1‐page patient‐specific feedback form based on patient’s self‐reported responses	To evaluate the  SICG   SICG + training, including support for response documentation and patient/family materials	To  evaluate QPL effects on patient/carers’ EoL care topic discussions in consultations   QPL for patients and caregivers	To improve patient‐centred communication between physicians and patients/carers   Complex patient‐centred communication training (2 components: physician, patient)	To improve communication between family and ICU staff and support family decision‐making   Proactive communication family conference plus bereavement information leaflet	To provide information and support to surrogates of patients with advanced dementia   Face‐to‐face structured conversation, telephone follow‐up	To increase patients’ EoL care discussions and cue oncologists to endorse QPL and question asking   Nurse‐led CSP (QPL, booster and verbal/written cueing of oncologists pre‐consultation)
Comparator (usual care)	Usual care (no additional education, training, support)	Usual care (no patient‐specific feedback)	Usual care	Usual care (routine consultation with PC physician)	Usual care (oncologist met with research assistant but received no training)	Usual care (routine family EoL conference); informs family of treatment limitations and that death is imminent; led by senior physician, with at least 1 family member	Usual care plus social contact by telephone (baseline and 2‐monthly to discuss whatever surrogate raised; each call mean 10 minutes)	Usual care (no contact with nurse, QPL, oncologists cueing to endorse QPL or question asking)
Provider (and training) and Recipient	Nurse‐led   Trained as PCPC: organisation, facilitation and follow‐up of CC (family, multidisciplinary staff, external health professionals)   Recipient: family members, in conference with healthcare professionals and residential home staff	Clinicians   No training described   Recipient: patients, surrogates, clinicians	Clinicians   Training: 2.5 hour programme, small groups. Included demonstration and discussion of SICG, role play  with feedback. Additional feedback  after first SICG plus support (as needed)   Recipient: patients, clinicians	Physicians   No training described Recipient: patients, carers	Physicians, patient coaches Training: 3 days; included instructors in role of advanced cancer patient, role play, supporting materials   Patient training: QPL with coaching to identify most important questions/concerns/priorities   Recipient: patients, carers, physicians	Physician‐led family conference   Training: intervention meeting for investigators at each ICU site; copy of VALUE guideline. Member of study team visited each site to discuss guidelines and ensure differences between intervention and UC understood   Recipient: family members	PCT physician, social worker   Training: structured meeting elements reviewed in training session   Recipient: surrogates	Trained senior nurses   Training: 2 nurses; each receiving 40 hours’ training   Recipient: patient/carer Oncologist
When and how  much	Single session   Timing: variable, median 48 minutes (IQR 30 to 60)	Patients received 1‐page patient‐specific feedback via mail, to review with surrogate before consultation   Patient‐specific feedback provided to clinician and patients on day of visit (for use during consultation)	Intervention delivered over 1 or more consultations. Pre‐visit letter introducing SICG topics sent to patient (activate and prepare them for conversation)   SICG used at consultation. Clinicians triggered by researchers to have SICG conversation (by email day before/ study materials on consultation day)	Once   Participants received QPL 20 to 30 minutes before PC physician consultation	Physician training: 2 educational outreach sessions. 1st session 1 hour; 2nd booster session 45 minutes 1 month later Patients/carers: coaching session (approx. 35 to 40 minutes) 1 hour prior to consultation; follow‐up phone calls (up to 3 monthly intervals)	Once, following 3 information meetings Proactive communication conference, conducted via guidelines. Planned in advance; included senior and junior physicians, nurses, psychologist, family and friends   Family members given bereavement information leaflet, content explained orally	Once, structured face‐to‐face meeting at care facility; mean duration 47 minutes (range 20 to 75 minutes)   Social worker contacted surrogates at baseline and every 2 months via telephone	Once, face‐to‐face session with nurse, 45 minutes, 1 week before follow‐up oncology consultation; private room. Carers attended where possible   Follow‐up telephone (booster) 1 to 2 weeks after consultation following CSP delivery; 15 minutes   Oncologists: verbally cued by nurses immediately before consultation following CSP; plus postcard
Tailoring	Yes; topics tailored to those important to the resident   Discussion topics tailored to what was important to the resident. Could include care planning, current/future treatment decision‐making, information sharing, residents’ needs/preferences, ACP   Agenda set with input from family members and staff involved in case	Yes; patient‐specific feedback included patient‐specific highest‐ranked barrier and facilitator to EoL communication, with introductory sentence for clinician use to lower  threshold to start conversations; patient’s 3 most important preferences for EoL experiences	Unclear; clinicians could split conversation across consultations but required to continue until all EMR module questions complete	Yes; QPL purpose to assist patients to identify questions of most importance and to raise these in consultation	Tailoring: oncologists’ training was individualised. Coaching tailored to patient/carer priorities and concerns for upcoming consultation	Not stated explicitly; family members had opportunity to ask questions, discuss treatment options (both intervention and UC groups)	Yes; meetings and follow‐up phone calls aimed to cover issues surrogates wished to discuss	Yes; QPL explored with patients to identify priority questions and discuss skills for question asking
Content	Predefined clinical triggers for CC; shared agenda setting model (resident, family, multidisciplinary team); required attendance by resident and/or family/decision makers; facilitation by PCPC to ensure optimal participation by attendees; communication strategy to summarise CC actions and plan	Patient‐specific feedback form generated from patient questionnaire responses, selected automatically (computerised process)   Selected responses included: whether their physician would know what care they would like, desire for communication about ACP, patient‐specific barriers and facilitators to communication about EoL care, preferences for CPR	SICG guide for clinicians in values and goals conversations, 7 elements: illness understanding, decision‐making and information preferences; prognostic disclosure; patient goals and fears; views on acceptable function and trade‐offs; desires for family involvement   Clinician documents discussion outcomes via structured EMR form (reminds clinicians of key discussion elements, enables documentation, able to be accessed by other clinicians). Family Communication Guide provided at consultation, suggesting approach for discussing illness/care preferences with family	QPL: 16‐page A5 booklet containing 112 questions grouped into 9 topics encompassing issues that may be discussed with physician or another health professional	Physician and patient interventions focused on same 4 elements of patient‐centred communication: engaging patients in consultations, responding to emotions, informing patients about choices for treatment and prognosis, and framing information in a balanced way	Proactive family communication conference; information on diagnosis, prognosis, treatment and discussed appropriateness of treatment limitations with family. Intensivist leading conference sought to achieve values represented by VALUE mnemonic (Value and appreciate things family says, Acknowledge emotions, Listen, ask questions that allow Understanding of who the patient is as a person, and Elicit questions from family)   Family bereavement information leaflet: 15 pages explaining EoL care, possible reactions after death of a family member, how to communicate with other family members, where to find help	Structured meeting to provide information and support to surrogates, including about treatment decisions that may arise  with worsening dementia severity. PCT available for further information/assistance with decision‐making; only 3 surrogates requested additional information   Social worker follow‐up contacts provided support, presented opportunity for surrogates to raise concerns and designed to continue discussions about issues raised in face‐to‐face meeting	Face‐to‐face session based on QPL, introduced by nurse. QPL  systematically explored to identify questions (including  prognosis, treatment options and decisions, palliative care, patient and family support, ACP and carer‐specific issues). Prognosis and EoL care issues highlighted, skills for question asking discussed   Participants given DVD on ACP and documenting wishes for care relevant to New South Wales   Participants prompted to identify 1 to 3 questions to ask at next consultation   Follow‐up (booster) phone call; 15 minutes 1 to 2 weeks post‐consultation. Sought to reinforce face‐to‐face meeting content,  prepare patients for future consultations using QPL   Nurses verbally cued oncologists prior to consultation; oncologists received postcard with suggested endorsement phrasing

ACP: advance care plan; CC: case conference; CSP: communication support programme; EMR: electronic medical record; EoL: end of life; ICU: intensive care unit; IQR: interquartile range; PC: palliative care; PCPC: palliative care planning co‐ordinator; PCT: primary care team; QPL: question prompt list; SICG: Serious Illness Conversation Guide; UC: usual care.

*Co‐intervention(s): ICUs were part of the FAMIREA study; providing 3 formal early information meetings for all families. First meeting 24 hours (general information on diagnosis, prognosis, treatments) plus information leaflet; second meeting 48 hours (answering questions, additional information check family understanding of situation); third meeting day 3 to 5 (treatments and prognosis explained, family questions answered).

If patient was expected to die (after 3 meetings) or shift to palliative care was indicated an EoL conference was held (i.e. intervention or routine conference). Co‐interventions involved extensive information provision; authors note this may have lessened differences between intervention and UC groups for some outcomes.