The effectiveness of interventions to increase advance directive completion rates

Mary Ann Jezewski, Mary Ann Meeker, Loralee Sessanna, Deborah S. Finnell

Research output: Contribution to journalArticlepeer-review

76 Scopus citations


Objectives: 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. Discussion: 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.

Original languageEnglish (US)
Pages (from-to)519-536
Number of pages18
JournalJournal of Aging and Health
Issue number3
StatePublished - Jun 2007
Externally publishedYes


  • Advance directives
  • Intervention
  • Systematic review

ASJC Scopus subject areas

  • Health(social science)
  • Sociology and Political Science
  • Life-span and Life-course Studies


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