Effectiveness of Palliative Care in Advanced Heart Failure: A Comprehensive Meta-Analysis

Abstract

Advanced heart failure (HF) significantly diminishes quality of life (QoL) due to severe symptom burden and psychological distress. This meta-analysis investigates the impact of palliative care interventions on QoL, psychological well-being, symptom burden, and mortality in adults with advanced HF. A systematic search of major databases through August 2024 identified 13 randomized controlled trials involving 1541 participants from the USA, China, Iran, and Sweden. Palliative care significantly improved QoL scores compared with usual care [mean difference (MD) = 1.36; 95% confidence interval (CI), 0.89-1.83; P < 0.00001], with notable improvements using the Kansas City Cardiomyopathy Questionnaire. Palliative care significantly reduced anxiety scores (MD = -0.39; 95% CI, -0.66 to -0.11), P = 0.006), especially when assessed with the Edmonton Symptom Assessment Scale. While no significant differences were observed for dyspnea or depression (P =0.56, P = 0.23, respectively). Mortality rates did not differ significantly between groups (P = 0.61). These findings highlight the potential of palliative care, particularly interventions incorporating symptom management and psychological support, to enhance QoL and reduce anxiety in advanced HF patients. However, further research is required to standardize these interventions and evaluate their long-term outcomes.