title: The effectiveness of interventions to increase advance directive completion rates.
abstract: OBJECTIVE
  Despite federal and state laws governing advance directives (ADs), interventions to increase rates of legally completed ADs have not produced significant results. This study synthesizes the state of the science regarding effectiveness of interventions to increase AD completion rates.
  
  
  METHODS
  Garrard's method for conducting a systematic literature review was followed. In all, 25 studies meeting inclusion criteria were reviewed. Interventions fell into two types: (a) didactic-information distributed through an educational program or clinical encounter or by a mailing and (b) interactive-person-to-person interaction where participants had the opportunity to ask questions and/or receive assistance completing the forms.
  
  
  RESULTS
  Postintervention rates of AD completion were: didactic = no change to 34% increase; interactive = 23% to 71% increase.
  
  
  CONCLUSIONS
  Education without the ability to ask questions does not significantly increase the AD completion rate. Didactic interventions did not usually increase completion rates higher than the predicted average rate for the general population.
authors.affiliation: School of Nursing, University at Buffalo, the State University of New York, 921 Kimball Tower, Buffalo, NY 14214-3079, USA. jezewski@buffalo.edu
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Jezewski
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Meeker
authors.forename: Loralee
authors.initials: L
authors.lastname: Sessanna
authors.forename: Deborah S
authors.initials: DS
authors.lastname: Finnell
mesh_terms: D000293:Adolescent; D000328:Adult; D016223:Advance Directives; D000368:Aged; D000369:Aged, 80 and over; D003376:Counseling; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D010358:Patient Participation; D024382:Professional Role; D012196:Review Literature as Topic; D014481:United States