Motivational Interviews to Enhance Advance Care Plans in Older Adults: Systematic Review: A Systematic Review

Abstract

<p>Background: Motivational interview (MI) counseling has been widely adopted by health professionals as a therapeutic communication strategy to increase patients’ motivation for beneficial health behavior changes. Advance care planning (ACP) programs that incorporate motivational interviewing also emerged. </p><p>Aim: The aim is to integrate the quantitative and qualitative evidence to understand the feasibility, appropriateness, meaningfulness, and effectiveness of motivational-interview-based, ACP interventions for older adults. </p><p>Design: A systematic review was undertaken to identify ACP interventions with a motivational interview approach. </p><p>Data sources: We searched MEDLINE/PubMed, ERIC, PsycINFO, and CINAHL from the inception of the databases for descriptive, experimental, and mixed-methods studies. </p><p>Registration: The review was registered in the PROSPERO database (CRD42022341178). </p><p>Results: We identified 13 articles from trialing of seven interventions, including four randomized control trials, six feasibility, and three qualitative studies. The synthesized evidence showed that the application of motivational interviewing skills in ACP was feasible and well-received by the elderly. The meta-analysis also showed that MI-based intervention was effective in increasing the documentation of advance directives and health care delegates in older adults. </p><p>Conclusions: Motivational interviewing counseling is a promising intervention for older adults in ACP conversations. Particularly, training lay persons to deliver MI-based counseling for older adults in the community is feasible. <br></p><p><br></p><p>Keywords: advance directive, advance care planning, motivational interviewing, palliative care </p><p><br></p>