Summary by Dr Markus Schichtel, GP and post-doctoral researcher at the Palliative and End of Life Care Group at the Primary Care Unit, University of Cambridge.
National and international guidelines advocate advance care planning (ACP) to facilitate better end-of-life care in heart failure. ACP is a voluntary process of discussion between patients, family clinicians and important others to identify the patient’s preferences and values of care if the patient may be unable to make such decisions in the future.
Several trials demonstrate that ACP can improve quality of life, lower hospital admissions or re-admissions in heart failure. But studies show that clinicians often do not engage with ACP.
Behaviour change techniques that are effective in supporting healthcare professionals to change their behaviour and adopt ACP into practice could increase the engagement of clinicians with ACP.
In this review we synthesised the evidence for behaviour change techniques with the greatest potential to engage clinicians with ACP.
We screened 14483 articles and reviewed the full text of 131 papers. 13 randomised clinical trials representing 3709 participants met our inclusion criteria.
The most effective behavioural change techniques are:
Goal setting (outcome)
Instruction on behaviour performance
These findings can inform clinical services to consider how best to introduce ACP amongst clinicians caring for patients with heart failure.
Read the research
Schichtel, M., Wee, B., Perera, R., Onakpoya, I., Albury, C., Effect of Behavior Change Techniques Targeting Clinicians to Improve Advance Care Planning in Heart Failure: A Systematic Review and Meta-Analysis Annals of Behavioural Medicine 14 September 2020
Find out more about our work on Advance Care Planning
This research alert is for those working in healthcare. It summarises the case for interventions to engage clinicians in advance care planning with heart failure patients and sets out the latest findings from our research into what interventions work.
Advance care planning significantly improves quality of life for patients with heart failure, concludes the first systematic evaluation of published evidence on this topic, led by Dr Markus Schichtel at the Primary Care Unit, University of Cambridge.