Dixon J, et al. – This systematic review aimed to evaluate the empirical evidence concerning the effectiveness of advance care planning (ACP) in improving end of life outcomes for people with dementia and their carers. The authors revealed that there was a need for more high–quality outcome studies, especially using randomized designs to control for confounding. To clarify the appropriateness of outcome measures, explore implementation issues and to identify ‘active elements’, these needed to be underpinned by sufficient development work and process evaluation.

• The authors conducted systematic searches of academic databases (CINAHL Plus with full text, PsycINFO, SocINDEX with full text and PubMed) to identify research studies, January 2000 - January 2017, involving statistical methods, in which ACP was an intervention or independent variable, and in which end of life outcomes for people with dementia and/or their carers are reported.

• The authors identified 18 relevant studies.
• In this study, most found ACP to be correlated with some improved end of life outcomes.
• Studies were predominantly from the US and care home-based, but not exclusively.
• Type of ACP and outcome measures varied.
• They assessed quality using NICE quality appraisal checklists.
• Over half of the investigations were of moderate to high quality (3 were randomized controlled trials, 2 of which were low quality).