SynthesisBMC palliative care2025
Barriers to and readiness for advance care planning: a systematic review and meta-analysis of quantitative and qualitative evidence.
Synthesis in BMC palliative care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis 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
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Determinants of Interest-Holder Perspectives Toward Post-Mortem Tissue Donation in Oncology: A Systematic Review.Psycho-oncology · 2026Pooled it
- Article
- Considerations in referring older patients to hospital in acute situations: a qualitative study based on the experiences of healthcare providers.BMC primary care · 2026Article
- Impact of Legal Protection on Life-Support Interventions and 3-Month Mortality in the Intensive Care Unit: The Vulne-Rea Study.Healthcare (Basel, Switzerland) · 2026Article
- Advance care planning for patients with advanced multiple long-term conditions: a qualitative thematic analysis of health and social care professionals' perspectives.BMC palliative care · 2026Article
- Qualitative study on influencing factors of acceptance of advance care planning in patients with end-stage heart failure based on COM-B theory.Frontiers in public health · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAdvance care planning (ACP) allows individuals to express their values and preferences for future medical care, yet participation remains low globally. Understanding readiness for ACP and the barriers and facilitators influencing engagement is essential for effective implementation.
methodsFollowing Joanna Briggs Institute (JBI) and PRISMA 2020 guidelines, a comprehensive search was conducted across PubMed, Embase, Scopus, Web of Science, Cochrane Library, and grey literature up to September 2025. Quantitative, qualitative, and mixed-methods studies involving adults (patients, families, or healthcare providers) were included. Quantitative data on ACP readiness or acceptance were pooled using a random-effects meta-analysis, while qualitative data were synthesized thematically. Study quality was appraised using CASP, NOS, and Cochrane RoB tools; certainty of evidence was assessed using GRADE and GRADE-CERQual frameworks.
resultsTwenty-nine studies (n = 15,565 participants) from eight countries met inclusion criteria. Barriers to ACP were identified at the patient (emotional discomfort, limited awareness, cultural taboos), family (overprotection, conflict, poor communication), provider (time constraints, lack of training, role ambiguity), and system (insufficient policies, documentation challenges, and fragmented care) levels. Facilitators included family support, early provider initiation, structured protocols, and culturally sensitive communication. The pooled mean ACP readiness score across four studies (n = 856) was 77.23 (95% CI: 67.86-86.61), indicating moderate readiness with substantial heterogeneity (I² = 99.4%). Readiness was positively associated with family support, prior caregiving experience, and active coping styles.
conclusionsGlobal readiness for ACP remains moderate and is constrained by emotional, familial, professional, and systemic barriers. Enhancing communication, training, and supportive institutional frameworks is essential to strengthen ACP engagement and promote person-centered end-of-life care. REGISTRATION: CRD420251172759.
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