OBJECTIVES: This evidence-based analysis (EBA) is a systematic review of the effectiveness of patient care planning discussions (PCPDs) between patients/ families and providers in improving patient-centred outcomes for people nearing the end of life (EoL).  METHODS: A literature search was performed using MEDLINE, Embase, CINAHL, and EBM Reviews for studies published from January 1, 2004 to October 9, 2013. Included studies must be in English, include adults at the EoL, utilize selected study designs [i.e. randomized controlled trials (RCTs), observational studies, systematic reviews, meta-analyses], and focus on discussion-based interventions for planning EoL care. Titles and abstracts were reviewed by a single reviewer and full-text articles were obtained when appropriate. Reference lists were examined for additional relevant studies. The quality of the evidence was evaluated using GRADE. When appropriate, meta-analyses were performed.  RESULTS: The search yielded 5,316 citations, and 13 RCTs and 17 observational studies were selected for inclusion in the quantitative evidence synthesis, which is still underway. Preliminary results showed that, compared to no PCPDs, PCPDs involving providers from at least one discipline led to increases in quality of life (QOL). Interventions that included tools to facilitate PCPDs (e.g. question list) did not perform better than their controls (2 studies showing mean differences of 0.01, p>0.05 and 0.10, p>0.05). Having PCPDs earlier in the illness course was associated with higher QOL (adjβ=0.003, p=0.006; 1 study). PCPDs with a multidisciplinary team of providers led to fewer days in the intensive care unit (ICU) [pooled estimate: -6.68 (95% CI: -10.71, -2.65); 2 studies].   CONCLUSIONS: PCPDs contribute to improving QOL for patients at the EoL and reduce the time they spend in the ICU. This systematic review is part of a mega-analysis (a multi-intervention appraisal) about EoL care, and its recommendations will inform policies regarding the delivering quality EoL care for Ontarians.