SynthesisPloS one2018
Barriers and facilitators for GPs in dementia advance care planning: A systematic integrative review.
Synthesis in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 59 papers, 5 of them syntheses that pooled it.
What it found
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
59 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Navigating the Threshold: Barriers and Facilitators to Accessing Primary Care Among People Living with Dementia-A Systematic Review and Meta-Synthesis.International journal of environmental research and public health · 2026Pooled it
- Factors associated with participation in advance care planning among people with different degrees of cognitive impairment: a systematic review.BMC palliative care · 2026Pooled it
- [Evidence on Advance Care Planning for People with Dementia - A Systematic Review (2017-2023)].Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany)) · 2026Pooled it
- Optimizing the diagnosis and management of dementia within primary care: a systematic review of systematic reviews.BMC family practice · 2021Pooled it
- Exploring how triads of people living with dementia, carers and health care professionals function in dementia health care: A systematic qualitative review and thematic synthesis.Dementia (London, England) · 2021Pooled it
- 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
- Recruiting general practitioners and patients with dementia into a cluster randomised controlled trial: strategies, barriers and facilitators.BMC medical research methodology · 2021Trial
- Advance care planning with people with dementia: a process evaluation of an educational intervention for general practitioners.BMC family practice · 2020Trial
- Bringing up the end of life and euthanasia. A mixed method study on consultations with people with dementia and their families in the hospital setting.Palliative medicine · 2026Article
- Factors influencing readiness for advance care planning in dementia: a qualitative interview study.BMC palliative care · 2026Article
- A program of SUPPORT-DPalliative & supportive care · 2026Article
- Patient- and Caregiver-Identified Goals for Advance Care Planning in Patients With Dementia or Cognitive Impairment.Dementia (London, England) · 2026Article
- Article
- Hindering Factors and Perceived Needs for the Decision Making of Advanced Directives Among People with Dementia and Their Families.Geriatrics (Basel, Switzerland) · 2025Article
- Shared care planning in people with cognitive disorders and dementia: a survey among patients and caregivers in Italy.BMC medical ethics · 2024Article
- Understanding Dementia Carer Experiences Before Admission to a Residential Aged Care Facility: Implications for Integrated Care.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2024Article
- Future policy and research for advance care planning in dementia: consensus recommendations from an international Delphi panel of the European Association for Palliative Care.The lancet. Healthy longevity · 2024Article
- Study protocol for the development and validation of a clinical prediction tool to estimate the risk of 1-year mortality among hospitalized patients with dementia.Diagnostic and prognostic research · 2024Article
- Article
- Palliative Care in Nursing Home Residents with Young-Onset Dementia: Professional and Family Caregiver Perspectives.Journal of Alzheimer's disease : JAD · 2024Observational
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDue to the disease's progressive nature, advance care planning (ACP) is recommended for people with early stage dementia. General practitioners (GPs) should initiate ACP because of their longstanding relationships with their patients and their early involvement with the disease, however ACP is seldom applied.
aimTo determine the barriers and facilitators faced by GPs related to ACP with people with dementia. DATA SOURCES: We systematically searched the relevant databases for papers published between January 1995 and December 2016, using the terms: primary healthcare, GP, dementia, and ACP. We conducted a systematic integrative review following Whittemore and Knafl's method. Papers containing empirical data about GP barriers and/or facilitators regarding ACP for people with dementia were included. We evaluated quality using the Mixed-Method-Appraisal-Tool and analyzed data using qualitative content analysis.
resultsTen qualitative, five quantitative, and one mixed-method paper revealed four themes: timely initiation of ACP, stakeholder engagement, important aspects of ACP the conversation, and prerequisites for ACP. Important barriers were: uncertainty about the timing of ACP, how to plan for an uncertain future, lack of knowledge about dementia, difficulties assessing people with dementia's decisional capacities, and changing preferences. Facilitators for ACP were: an early start when cognitive decline is still mild, inclusion of all stakeholders, and discussing social and medical issues aimed at maintaining normal life.
conclusionDiscussing future care is difficult due to uncertainties about the future and the decisional capacities of people with dementia. Based on the facilitators, we recommend that GPs use a timely and goal-oriented approach and involve all stakeholders. ACP discussions should focus on the ability of people with dementia to maintain normal daily function as well as on their quality of life, instead of end-of-life-discussions only. GPs need training to acquire knowledge and skills to timely initiate collaborative ACP discussions.
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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.