Affiliation:
1. Department of Public Health and Primary Care, University of Cambridge, Forvie Site, Biomedical Campus, Cambridge, UK
2. Oxford Centre for Education and Research in Palliative Care, Oxford University Hospital Trust, Oxford, UK
3. Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
Abstract
Abstract
Background
National and international guidelines recommend advance care planning (ACP) for patients with heart failure. But clinicians seem hesitant to engage with ACP.
Purpose
Our aim was to identify behavioral interventions with the greatest potential to engage clinicians with ACP in heart failure.
Methods
A systematic review and meta-analysis. We searched CINAHL, Cochrane Central Register of Controlled Trials, Database of Systematic Reviews, Embase, ERIC, Ovid MEDLINE, Science Citation Index, and PsycINFO for randomized controlled trials (RCTs) from inception to August 2018. Three reviewers independently extracted data, assessed risk of bias (Cochrane risk of bias tool), the quality of evidence (Grading of Recommendation Assessment, Development, and Evaluation), and intervention synergy according to the behavior change wheel and behavior change techniques (BCTs). Odds ratios (ORs) were calculated for pooled effects.
Results
Of 14,483 articles screened, we assessed the full text of 131 studies. Thirteen RCTs including 3,709 participants met all of the inclusion criteria. The BCTs of prompts/cues (OR: 4.18; 95% confidence interval [CI]: 2.03–8.59), credible source (OR: 3.24; 95% CI: 1.44–7.28), goal setting (outcome; OR: 2.67; 95% CI: 1.56–4.57), behavioral practice/rehearsal (OR: 2.64; 95% CI: 1.50–4.67), instruction on behavior performance (OR: 2.49; 95% CI: 1.63–3.79), goal setting (behavior; OR: 2.12; 95% CI: 1.57–2.87), and information about consequences (OR: 2.06; 95% CI: 1.40–3.05) showed statistically significant effects to engage clinicians with ACP.
Conclusion
Certain BCTs seem to improve clinicians’ practice with ACP in heart failure and merit consideration for implementation into routine clinical practice.
Publisher
Oxford University Press (OUP)
Subject
Psychiatry and Mental health,General Psychology
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献