Trial reportJournal of pain and symptom management2018
Improving a Full Range of Advance Care Planning Behavior Change and Action Domains: The PREPARE Randomized Trial.
Trial report in Journal of pain and symptom management, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 3 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Barriers to and readiness for advance care planning: a systematic review and meta-analysis of quantitative and qualitative evidence.BMC palliative care · 2025Pooled it
- Publicly Available, Interactive Web-Based Tools to Support Advance Care Planning: Systematic Review.Journal of medical Internet research · 2022Pooled it
- Development of a theory-based intervention to increase cognitively able frail elders' engagement with advance care planning using the behaviour change wheel.BMC health services research · 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
- Randomised trial of a serious illness decision aid (Plan Well Guide) for patients and their substitute decision-makers to improve engagement in advance care planning.BMJ supportive & palliative care · 2022Trial
- Empowering Older Adults to Discuss Advance Care Planning During Clinical Visits: The PREPARE Randomized Trial.Journal of the American Geriatrics Society · 2020Trial
- Brief English and Spanish Survey Detects Change in Response to Advance Care Planning Interventions.Journal of pain and symptom management · 2019Trial
- A Mixed-Methods Comparison of Interventions to Increase Advance Care Planning.Journal of the American Board of Family Medicine : JABFMTrial
- From inferring preferences to enabling choice: potentials of digital tools to improve substitute decision-making.Frontiers in digital health · 2026Article
- Article
- Translation, Cultural Adaptation and Validation of the Advance Care Planning Engagement Survey for Korean Older People.International journal of older people nursing · 2025Article
- Measuring decision aid effectiveness for end-of-life care: A systematic review.PEC innovation · 2024Article
- Reliability and Validation Study of Advance Care Planning Practice Scale among Health and Social Care Professionals.Healthcare (Basel, Switzerland) · 2024Article
- Tools for tomorrow: a scoping review of patient-facing tools for advance care planning.Palliative care and social practice · 2024Article
- Systems for electronic documentation and sharing of advance care planning preferences: a scoping review.Progress in palliative care · 2024Article
- The Web-Based Advance Care Planning Program "Explore Your Preferences for Treatment and Care": Development, Pilot Study, and Before-and-After Evaluation.Journal of medical Internet research · 2022Article
- Complex advance care planning interventions for chronic serious illness: how do they work: a scoping review.BMJ supportive & palliative care · 2021Review
- Measuring advance care planning behavior in Dutch adults: translation, cultural adaptation and validation of the Advance Care Planning Engagement Survey.BMC medical research methodology · 2021Article
- Facilitating advance care planning in the general practice setting for patients with a chronic, life-limiting illness: protocol for a phase-III cluster-randomized controlled trial and process evaluation of the ACP-GP intervention.BMC palliative care · 2021Article
- Deconstructing the Complexities of Advance Care Planning Outcomes: What Do We Know and Where Do We Go? A Scoping Review.Journal of the American Geriatrics Society · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
contextAdvance care planning (ACP) engagement includes a wide range of behaviors and actions related to discussions and documentation, yet few ACP intervention studies measure the full process.
objectivesThe objective of the study was to compare the effects of an easy-to-read advance directive (AD) versus an ACP web site plus the AD (PREPARE + AD) on Behavior Change Processes and Actions, including discussions and documentation.
methodsSecondary data were from a completed ACP trial. Participants were primary care patients, ≥60 years old, with two comorbidities. We used the validated ACP Engagement Survey to examine six-month change in subscales measuring Behavior Change Processes (knowledge, contemplation, self-efficacy, readiness) and Actions (decision makers, quality of life, flexibility for decision makers, asking clinicians questions), specifically related to discussions and documentation. We used adjusted mixed-effects linear models to compare mean change and engagement over time.
resultsCompared to the AD-only, PREPARE + AD resulted in greater increases in all Behavior Change Processes subscales and Actions related to decision makers, quality of life, and flexibility (all P-values ≤0.005). Both interventions significantly increased the proportion of participants who engaged in ACP discussions (PREPARE + AD, 99.5%; AD-only, 93.3%) and documentation (PREPARE + AD, 99.5%; AD-only, 90.4%), with greater increases for PREPARE + AD (all P-values <0.001).
conclusionBoth PREPARE plus an easy-to-read AD and an AD-only markedly increased ACP engagement in a full range of ACP behaviors, including discussions and documentation, and engagement was nearly 100% with PREPARE + AD. Future ACP studies should examine a full range of ACP behaviors beyond ADs and the impact of PREPARE and easy-to-read AD implementation on health care systems.
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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.