Background Advance care planning (ACP) is underutilised in patients with heart failure (HF); however, ACP needs to be introduced early in the illness trajectory as patients with HF progress through a rather non-linear and unpredictable trajectory characterised by sudden decompensations and death. Although the incidence of heart failure has declined in the past decade, because of improved HF therapies and an ageing population, the absolute number of HF cases is rising in Canada. Introduction of ACP is challenged by the patients’ perceptions about their health and lack of awareness about the severity of their illness, and by the perceptions of health care professionals of judging the timing to early and the patients not ready for such intervention.

Aim This literature review aims to conceptually define readiness, and to describe readiness to engage in ACP and its influential factors.

Methods A systematic literature search using major databases was conducted. Relevant articles were selected, critically appraised and synthesised.

Results Readiness is theoretically proposed to have three main domains: intention, attitudes and beliefs; however, most studies fail to conceptually define readiness. Studies are lacking on readiness in the HF populations and evidence with other patients suggest mixed levels of readiness to engage in ACP. Evidence on factors influencing readiness are inconclusive and most studies have methodological limitations.

Conclusion Future research is needed with strong theoretical foundations to explore readiness to engage in ACP of patients with HF. This will aid health care providers to target the modifiable variable to increase ACP participation.