Multicomponent interventions outperform single reminders for raising advance care plan completion in primary care

A narrative review of 40 studies published between 2000 and 2025 examined which interventions actually raise advance care planning (ACP) completion in primary care Synthesis. Multicomponent interventions — combining professional education or training, decision aids, systems-level prompts, and dedicated ACP consultations — most consistently raised completion of advance care directives. Single-component reminders alone, without the other elements, were consistently weaker.

This is the broadest currently available review of what moves ACP completion rates specifically within primary care, drawing on a quarter-century of published intervention studies conducted internationally, rather than a single trial or setting.

For any primary care service designing an ACP improvement effort, this directly favours bundled, multicomponent approaches — training plus decision aids plus systems prompts plus dedicated consultation time — over relying on a single reminder mechanism alone.