SynthesisScandinavian journal of primary health care2013
Barriers and facilitators for general practitioners to engage in advance care planning: a systematic review.
Synthesis in Scandinavian journal of primary health care, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 101 papers, 9 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Randomized Control Trial of an Advance Care Planning Intervention to Engaged Substitute Decision-makers in Primary Care
A Randomized Trial of ACP/GCD Care Pathway in Primary Care in Alberta
Who cites it
101 citing papers in PubMed, 9 syntheses or guidelines pooled it, 288 citations in OpenAlex.
- Barriers to and readiness for advance care planning: a systematic review and meta-analysis of quantitative and qualitative evidence.BMC palliative care · 2025Pooled it
- Equitable inclusion of patients with cancer on the palliative care register: a systematic review in primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025Pooled it
- Experiences and perspectives of healthcare professionals implementing advance care planning for people suffering from life-limiting illness: a systematic review and meta-synthesis of qualitative studies.BMC palliative care · 2023Pooled it
- Barriers and facilitators to clinical behaviour change by primary care practitioners: a theory-informed systematic review of reviews using the Theoretical Domains Framework and Behaviour Change Wheel.Systematic reviews · 2022Pooled it
- Individual, health system, and contextual barriers and facilitators for the implementation of clinical practice guidelines: a systematic metareview.Health research policy and systems · 2020Pooled it
- Pooled it
- Barriers and facilitators for GPs in dementia advance care planning: A systematic integrative review.PloS one · 2018Pooled it
- Improving hospital-based end of life care processes and outcomes: a systematic review of research output, quality and effectiveness.BMC palliative care · 2017Pooled it
- Physician-related barriers to communication and patient- and family-centred decision-making towards the end of life in intensive care: a systematic review.Critical care (London, England) · 2014Pooled it
- Trial
- Experiences with implementing advance care planning (ACP-GP) in Belgian general practice in the context of a cluster RCT: a process evaluation using the RE-AIM framework.BMC primary care · 2024Trial
- Feasibility and Acceptability of Facilitated Advance Care Planning in Outpatient Clinics: A Qualitative Study of Patient and Caregivers Experiences.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2024Trial
- Complex advance care planning intervention in general practice (ACP-GP): a cluster-randomised controlled trial.The British journal of general practice : the journal of the Royal College of General Practitioners · 2024Trial
- Advance care planning engagement in patients with chronic, life-limiting illness: baseline findings from a cluster-randomised controlled trial in primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2023Trial
- Primary Palliative Care Improves Uptake of Advance Care Planning Among Patients With Advanced Cancers.Journal of the National Comprehensive Cancer Network : JNCCN · 2023Trial
- Trial
- Adding a second surprise question triggers general practitioners to increase the thoroughness of palliative care planning: results of a pilot RCT with cage vignettes.BMC palliative care · 2018Trial
- Advance care planning in people with intellectual disabilities, more than 'to resuscitate or not to resuscitate': A qualitative interview study with general practitioners and family caregivers.The European journal of general practice · 2026Article
- Article
- Charting the future: A multi-setting medical chart study of advance care planning in Parkinson's disease and atypical Parkinsonism.Journal of Parkinson's disease · 2026Article
41 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe aim of this systematic review is to identify the perceived factors hindering or facilitating GPs in engaging in advance care planning (ACP) with their patients about care at the end of life.
designStudies from 1990 to 2011 were found in four electronic databases (PubMed, CINAHL, EMBASE, PsycINFO); by contacting first authors of included studies and key experts; and searching through relevant journals and reference lists. Studies were screened, graded for quality, and analysed independently by two authors; those reporting the perception by GPs of barriers and facilitators to engagement in ACP were included.
resultsEight qualitative studies and seven cross-sectional studies were included for data extraction. All barriers and facilitators identified were categorized as GP characteristics, perceived patient factors, or health care system characteristics. Stronger evidence was found for the following barriers: lack of skills to deal with patients' vague requests, difficulties with defining the right moment, the attitude that it is the patient who should initiate ACP, and fear of depriving patients of hope. Stronger evidence was found for the following facilitators: accumulated skills, the ability to foresee health problems in the future, skills to respond to a patient's initiation of ACP, personal convictions about who to involve in ACP, and a longstanding patient-GP relationship and the home setting.
conclusionInitiation of ACP in general practice may be improved by targeting the GPs' skills, attitudes, and beliefs but changes in health care organization and financing could also contribute.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.