Evidence map›Paper›PMID 28237955›Full record

Trial reportBMJ open2017

Advance care planning uptake among patients with severe lung disease: a randomised patient preference trial of a nurse-led, facilitated advance care planning intervention.

Craig Sinclair, Kirsten Anne Auret, Sharon Frances Evans, Fiona Williamson, Siobhan Dormer, Anne Wilkinson, Kim Greeve, Audrey Koay, Dot Price, Fraser Brims

Open access · goldAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed, 3 pooled it
8.9field-weighted citation impact, top 2% of its field
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

30 citing papers in PubMed, 3 syntheses or guidelines pooled it, 98 citations in OpenAlex.

  1. Pooled it
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  6. Article
  7. Health disparities and associated social determinants of health in interstitial lung disease: a narrative review.European respiratory review : an official journal of the European Respiratory Society · 2025
    Review
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  9. Review
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  11. Advance care planning in patients with respiratory failure.European respiratory review : an official journal of the European Respiratory Society · 2024
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 1 country.

Craig SinclairRural Clinical School of Western Australia, University of Western Australia, Albany, Western Australia, Australia.
Kirsten Anne AuretRural Clinical School of Western Australia, University of Western Australia, Albany, Western Australia, Australia.
Sharon Frances EvansRural Clinical School of Western Australia, University of Western Australia, Perth, Western Australia, Australia.
Fiona WilliamsonRural Clinical School of Western Australia, University of Western Australia, Albany, Western Australia, Australia.
Siobhan DormerRespiratory Department, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.
Anne WilkinsonSchool of Nursing and Midwifery, Edith Cowan University, Perth, Western Australia, Australia.ORCID 0000-0002-2406-6552
Kim GreeveDepartment of Health, WA Cancer and Palliative Care Network, Perth, Western Australia, Australia.
Audrey KoayDepartment of Health, WA Cancer and Palliative Care Network, Perth, Western Australia, Australia.
Dot PriceWestern Australian Country Health Service, District Health Advisory Committee, Albany, Western Australia, Australia.
Fraser BrimsRespiratory Department, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.
The University of Western Australia · AUGovernment of Western Australia Department of Health · AUSir Charles Gairdner Hospital · AUEdith Cowan University · AUWA Country Health Service · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveAdvance care planning (ACP) clarifies goals for future care if a patient becomes unable to communicate their own preferences. However, ACP uptake is low, with discussions often occurring late. This study assessed whether a systematic nurse-led ACP intervention increases ACP in patients with advanced respiratory disease.

designA multicentre open-label randomised controlled trial with preference arm.

settingMetropolitan teaching hospital and a rural healthcare network.

participants149 participants with respiratory malignancy, chronic obstructive pulmonary disease or interstitial lung disease.

interventionNurse facilitators offered facilitated ACP discussions, prompted further discussions with doctors and loved ones, and assisted participants to appoint a substitute medical decision-maker (SDM) and complete an advance directive (AD). OUTCOME MEASURES: The primary measure was formal (AD or SDM) or informal (discussion with doctor) ACP uptake assessed by self-report (6 months) and medical notes audit. Secondary measures were the factors predicting baseline readiness to undertake ACP, and factors predicting postintervention ACP uptake in the intervention arm.

resultsAt 6 months, formal ACP uptake was significantly higher (p<0.001) in the intervention arm (54/106, 51%), compared with usual care (6/43, 14%). ACP discussions with doctors were also significantly higher (p<0.005) in the intervention arm (76/106, 72%) compared with usual care (20/43, 47%). Those with a strong preference for the intervention were more likely to complete formal ACP documents than those randomly allocated. Increased symptom burden and preference for the intervention predicted later ACP uptake. Social support was positively associated with ACP discussion with loved ones, but negatively associated with discussion with doctors.

conclusionsNurse-led facilitated ACP is acceptable to patients with advanced respiratory disease and effective in increasing ACP discussions and completion of formal documents. Awareness of symptom burden, readiness to engage in ACP and relevant psychosocial factors may facilitate effective tailoring of ACP interventions and achieve greater uptake. TRIAL REGISTRATION NUMBER: ACTRN12614000255684.

Indexed as

Decision MakingPatient PreferenceAdvance DirectivesAgedAged, 80 and overAustraliaFemaleHumansLogistic ModelsLung DiseasesMaleMiddle AgedPatient-Centered CareTerminal CareAdvance care planningadvance directivemedical decision-makingrandomised controlled trialreadinessrespiratory disease

Identifiers

PMID28237955
PMCPMC5337715
OpenAlexW2589623684

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.