The Impact of Advance Care Planning on End-of-Life Care: A Scoping Review Across Five Critical Dimensions

Abstract

Objective

To identify and synthesize the available evidence on the impact of advance care planning on decision-making and end-of-life care.

Design

A scoping review was conducted following the Joanna Briggs Institute methodology. The results were grouped into thematic categories and presented in accordance with the PRISMA-ScR guidelines.

Inclusion Criteria

Documents published between 2006 and 2026 in English, Spanish, and Portuguese were included, provided they were available in full text and addressed the research question.

Information Sources

The PubMed, Scopus, Web of Science, and BIREME databases were used. Additionally, the snowball sampling method was employed to expand the search.

Results

A total of 2816 records were identified through database searches and secondary tracking, of which 30 were selected for the final review. The identified impacts were organized into a conceptual framework comprising five interrelated dimensions: care congruence, healthcare utilization, economic and cost outcomes, family and caregiver impact, and patient quality of life. Each category is enriched by a set of interrelated components that describe various clinical, psychosocial, and financial outcomes reported in the literature.

Conclusions

Although advance care planning is not a new concept, this review provides an updated and integrated framework that highlights five interrelated domains of impact fundamental to the quality of end-of-life care. These findings suggest the potential value of considering ACP within patient-centered and value-based care models, while underscoring the relevance of future research aimed at informing the sustainability and humanization of end-of-life care.

Keywords

advance planning advance directives decision-making living will end-of-life care care goals

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