SynthesisJournal of general internal medicine2020
The Effect of Advance Care Planning on Heart Failure: a Systematic Review and Meta-analysis.
Synthesis in Journal of general internal medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 4 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
51 citing papers in PubMed, 4 syntheses or guidelines pooled it, 120 citations in OpenAlex.
- Palliative care interventions and outcomes in patients with heart failure: an umbrella review.Heart failure reviews · 2026Pooled it
- Evaluating outcomes of advance care planning interventions for adults living with advanced illness and people close to them: A systematic meta-review.Palliative medicine · 2025Pooled it
- Risk factors of vertebral re-fracture after PVP or PKP for osteoporotic vertebral compression fractures, especially in Eastern Asia: a systematic review and meta-analysis.Journal of orthopaedic surgery and research · 2022Pooled it
- Advance care plans and hospitalized frail older adults: a systematic review.BMJ supportive & palliative care · 2020Pooled it
- Preferences for advance care planning in patients with acute coronary syndrome across precursor and symptomatic heart failure stages.Heart and vessels · 2026Article
- FAIR-Birth: Development and Feasibility Testing of an AI-Supported Advance Birth Planning Application for Midwifery-Led Antenatal Care-A Mixed-Methods Study Protocol.Healthcare (Basel, Switzerland) · 2026Article
- Measurement instruments in advance care planning: A systematic review of psychometric properties.International journal of nursing studies advances · 2026Review
- Factors Associated with Advance Care Planning Engagement Among Community-Dwelling Older Adults: A Cross-Sectional Study.Journal of clinical nursing · 2026Article
- Healthcare utilization and end-of-life care based on life-sustaining treatment decisions in patients with cancer.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
- Embedding a Palliative Care Nurse Consultant Within a General Medicine Ward: A Prospective Exploratory Study.Journal of clinical nursing · 2026Article
- Attitudes to earlier advance care planning: a qualitative interview study in general practice.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026Article
- What is the appropriate timing for advance care planning according to patients and their relatives? A scoping review.PloS one · 2026Article
- Patterns and predictors of palliative care use in acute heart failure hospitalizations.American heart journal plus : cardiology research and practice · 2026Article
- Article
- Palliative Care in Decompensated Heart Failure Requiring Inotropic Therapy: Opportunities for Integration to Improve Outcomes.Arquivos brasileiros de cardiologia · 2025Observational
- Palliative Care and Advanced Cardiovascular Disease in Adults: Not Just End-of-Life Care: A Scientific Statement From the American Heart Association.Circulation · 2025Review
- Palliative care for cardiovascular patients: comparison of the motives of referral by cardiologists and the actual care provided by the mobile palliative care team.European geriatric medicine · 2025Article
- Response to Letter to the Editor: ACP in Medicare Beneficiaries with HF.Journal of general internal medicine · 2025Article
- Article
- Advance Care Planning (ACP) in Medicare Beneficiaries with Heart Failure.Journal of general internal medicine · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAdvance care planning is widely advocated to improve outcomes in end-of-life care for patients suffering from heart failure. But until now, there has been no systematic evaluation of the impact of advance care planning (ACP) on clinical outcomes. Our aim was to determine the effect of ACP in heart failure through a meta-analysis of randomized controlled trials (RCTs).
methodsWe searched CINAHL, Cochrane Central Register of Controlled Trials, Database of Systematic Reviews, Embase, ERIC, Ovid MEDLINE, Science Citation Index and PsycINFO (inception to July 2018). We selected RCTs including adult patients with heart failure treated in a hospital, hospice or community setting. Three reviewers independently screened studies, extracted data, assessed the risk of bias (Cochrane risk of bias tool) and evaluated the quality of evidence (GRADE tool) and analysed interventions according to the Template for Intervention Description and Replication (TIDieR). We calculated standardized mean differences (SMD) in random effects models for pooled effects using the generic inverse variance method.
resultsFourteen RCTs including 2924 participants met all of the inclusion criteria. There was a moderate effect in favour of ACP for quality of life (SMD, 0.38; 95% CI [0.09 to 0.68]), patients' satisfaction with end-of-life care (SMD, 0.39; 95% CI [0.14 to 0.64]) and the quality of end-of-life communication (SMD, 0.29; 95% CI [0.17 to 0.42]) for patients suffering from heart failure. ACP seemed most effective if it was introduced at significant milestones in a patient's disease trajectory, included family members, involved follow-up appointments and considered ethnic preferences. Several sensitivity analyses confirmed the statistically significant direction of effect. Heterogeneity was mainly due to different study settings, length of follow-up periods and compositions of ACP.
conclusionsACP improved quality of life, patient satisfaction with end-of-life care and the quality of end-of-life communication for patients suffering from heart failure and could be most effective when the right timing, follow-up and involvement of important others was considered.
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