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. 2022 Apr 20;24(4):e33320.
doi: 10.2196/33320.

Publicly Available, Interactive Web-Based Tools to Support Advance Care Planning: Systematic Review

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Publicly Available, Interactive Web-Based Tools to Support Advance Care Planning: Systematic Review

Charlèss Dupont et al. J Med Internet Res. .

Abstract

Background: There is an increasing number of interactive web-based advance care planning (ACP) support tools, which are web-based aids in any format encouraging reflection, communication, and processing of publicly available information, most of which cannot be found in the peer-reviewed literature.

Objective: This study aims to conduct a systematic review of web-based ACP support tools to describe the characteristics, readability, and quality of content and investigate whether and how they are evaluated.

Methods: We systematically searched the web-based gray literature databases OpenGrey, ClinicalTrials.gov, ProQuest, British Library, Grey Literature in the Netherlands, and Health Services Research Projects in Progress, as well as Google and app stores, and consulted experts using the following eligibility criteria: web-based, designed for the general population, accessible to everyone, interactive (encouraging reflection, communication, and processing of information), and in English or Dutch. The quality of content was evaluated using the Quality Evaluation Scoring Tool (score 0-28-a higher score indicates better quality). To synthesize the characteristics of the ACP tools, readability and quality of content, and whether and how they were evaluated, we used 4 data extraction tables.

Results: A total of 30 tools met the eligibility criteria, including 15 (50%) websites, 10 (33%) web-based portals, 3 (10%) apps, and 2 (7%) with a combination of formats. Of the 30 tools, 24 (80%) mentioned a clear aim, including 7 (23%) that supported reflection or communication, 8 (27%) that supported people in making decisions, 7 (23%) that provided support to document decisions, and 2 (7%) that aimed to achieve all these aims. Of the 30 tools, 7 (23%) provided information on the development, all of which were developed in collaboration with health care professionals, and 3 (10%) with end users. Quality scores ranged between 11 and 28, with most of the lower-scoring tools not referring to information sources.

Conclusions: A variety of ACP support tools are available on the web, varying in the quality of content. In the future, users should be involved in the development process of ACP support tools, and the content should be substantiated by scientific evidence.

Trial registration: PROSPERO CRD42020184112; https://tinyurl.com/mruf8b43.

Keywords: advance care planning; health communication; quality of online content; systematic review; web-based tools.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
PRISMA (Preferred Reporting Item for Systematic Reviews and Meta-Analyses) flowchart of the selection process.

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References

    1. Rietjens JA, Sudore RL, Connolly M, van Delden JJ, Drickamer MA, Droger M, van der Heide A, Heyland DK, Houttekier D, Janssen DJ, Orsi L, Payne S, Seymour J, Jox RJ, Korfage IJ, European Association for Palliative Care Definition and recommendations for advance care planning: an international consensus supported by the European Association for Palliative Care. Lancet Oncol. 2017 Sep;18(9):e543–51. doi: 10.1016/S1470-2045(17)30582-X.S1470-2045(17)30582-X - DOI - PubMed
    1. Sudore RL, Lum HD, You JJ, Hanson LC, Meier DE, Pantilat SZ, Matlock DD, Rietjens JA, Korfage IJ, Ritchie CS, Kutner JS, Teno JM, Thomas J, McMahan RD, Heyland DK. Defining advance care planning for adults: a consensus definition from a multidisciplinary Delphi panel (S740) J Pain Symptom Manage. 2017 May;53(5):821–32.e1. doi: 10.1016/j.jpainsymman.2016.12.331. https://linkinghub.elsevier.com/retrieve/pii/S0885-3924(16)31232-5 S0885-3924(16)31232-5 - DOI - PMC - PubMed
    1. Sinclair JB, Oyebode JR, Owens RG. Consensus views on advance care planning for dementia: a Delphi study. Health Soc Care Community. 2016 Mar;24(2):165–74. doi: 10.1111/hsc.12191. - DOI - PubMed
    1. Van den Block L. Advancing research on advance care planning in dementia. Palliat Med. 2019 Mar;33(3):259–61. doi: 10.1177/0269216319826411. - DOI - PubMed
    1. Prince-Paul M, DiFranco E. Upstreaming and normalizing advance care planning conversations-a public health approach. Behav Sci (Basel) 2017 Apr 12;7(2):18. doi: 10.3390/bs7020018. https://www.mdpi.com/resolver?pii=bs7020018 bs7020018 - DOI - PMC - PubMed

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