Video Conversation Aids to Assist in Goals-Of-Care Discussions With Older Adults in a Medical Setting: A Systematic Review.
Ashna S Karpe, Mokunfayo O Fajemisin, Stephanie Martinez Ugarte and 8 others
PMID 41424255WHAT IT FOUND
Video aids were often acceptable to older adults and sometimes improved goals-of-care knowledge or shifted preferences toward comfort care, but effects were inconsistent and did not always change documented decisions.
Key findings
01In two inpatient trials, older adults shown about six-minute videos were more likely to choose comfort care or avoid full code than controls.
02Some trials found no significant difference in code-status or CPR preferences between video and control groups.
03In the two satisfaction studies, most patients found the videos acceptable and helpful.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only five trials were included, each with 76 to 119 patients, so the review cannot show which video format works best. All trials had some concern or high risk of bias, including non-random sequence generation in one trial and no blinding of outcome assessors. The studies were too different for a meta-analysis, and they used videos of different lengths, content, and formats. The review excluded nursing home and community settings, non-US studies, and studies where the video was not the primary intervention. Most participants were stable older adults, not people with an acute decline or trauma, so it says little about urgent hospital decisions. No trial provided a clinical workflow for using the video, and preferences did not always match documented goals-of-care orders.
Declared interests
No funding or conflicts of interest were reported in the supplied text.
The easy way to misread this
Do not conclude that video aids reliably change end-of-life decisions. The review included only five trials, all with some concern or high risk of bias, and several preference outcomes were not significant.