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Influences on care preferences of older people with advanced illness: a systematic review and thematic synthesis

Etkind, Simon N.; Bone, Anna E.; Lovell, Natasha; Higginson, Irene J.; Murtagh, Fliss E.M.


Simon N. Etkind

Anna E. Bone

Natasha Lovell

Irene J. Higginson



To determine and explore the influences on care preferences of older people with advanced illness and integrate our results into a model to guide practice and research.


Systematic review using Medline, Embase, PsychINFO, Web of Science, and OpenGrey databases from inception to February 2017 and reference and citation list searching. Included articles investigated influences on care preference using qualitative or quantitative methodology. Thematic synthesis of qualitative articles and narrative synthesis of quantitative articles were undertaken.


Hospital and community care settings.


Older adults with advanced illness, including people with specific illnesses and markers of advanced disease, populations identified as in the last year of life, or individuals receiving palliative care (N = 15,164).


The QualSys criteria were used to assess study quality.


Of 12,142 search results, 57 articles were included. Family and care context, illness, and individual factors interact to influence care preferences. Support from and burden on family and loved ones were prominent influences on care preferences. Mechanisms by which preferences are influenced include the process of trading‐off between competing priorities, making choices based on expected outcome, level of engagement, and individual ability to form and express preferences.


Family is particularly important as an influence on care preferences, which are influenced by complex interaction of family, individual, and illness factors. To support preferences, clinicians should consider older people with illnesses and their families together as a unit of care.


Etkind, S. N., Bone, A. E., Lovell, N., Higginson, I. J., & Murtagh, F. E. (2018). Influences on care preferences of older people with advanced illness: a systematic review and thematic synthesis. Journal of the American Geriatrics Society, 66(5), 1031-1039.

Journal Article Type Review
Acceptance Date Feb 14, 2018
Online Publication Date Mar 7, 2018
Publication Date May 1, 2018
Deposit Date Jun 17, 2018
Publicly Available Date Jun 19, 2018
Journal Journal of the American Geriatrics Society
Print ISSN 0002-8614
Electronic ISSN 1532-5415
Publisher Wiley
Peer Reviewed Peer Reviewed
Volume 66
Issue 5
Pages 1031-1039
Keywords Systematic review; Patient preference; Terminally ill; Terminal care; Palliative care
Public URL
Publisher URL
Additional Information Copy of article first published in: Journal of the American Geriatrics Society, 2018, v.66, issue 5.


Article (116 Kb)

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Copyright Statement
© 2018 The Authors Journal of the American Geriatrics Society published by Wiley Periodicals, Inc. on behalf of The American Geriatrics Society. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

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