Conclusion
Overall, we did not find an effect of a concise ACP intervention on levels of patient activation or quality of life in community-dwelling older persons, which contributes to the growing evidence that ACP does not alter patient-reported outcomes. Interestingly, the completion of appointments of surrogates increased in both groups in our study, which might be interpreted in the way that already delivering a short written brochure and introducing ACP could be effective. However, our results are limited by the lack of statistical power and high dropouts. The fact that ACP discussion and documentation may be improved by these interventions, seems important for palliative care provision. Future trials need to identify effective elements of ACP interventions and a further debate on relevant outcomes is needed.