Effect of Palliative Care for Patients with Heart Failure: A Systematic Review and Meta-Analysis

Palliative care might be beneficial to heart failure. However, the results remain controversial. We conducted a systematic review and meta-analysis to explore the effect of palliative care on heart failure.PubMed, Embase, Web of Science, EBSCO, and Cochrane library databases were systematically searched. Randomized controlled trials (RCTs) assessing the effect of palliative care versus usual care on heart failure were included. Two investigators independently searched articles, extracted data, and assessed the quality of included studies. The primary outcome was readmission. Meta-analysis was performed using random-effect model.Five RCTs involving 545 patients were included in the meta-analysis. Overall, compared with control intervention, palliative care intervention was found to significantly reduce the readmission [Std. mean difference = 0.79; 95% confidence intervals (CI) = 0.23 to 1.35; P = 0.006], Edmonton Symptom Assessment Scale (ESAS) (Std. mean difference = -2.5; 95% CI = -4.39 to -0.62; P = 0.009), and PHQ-9 (Std. mean difference = -1.16; 95% CI = -1.73 to -0.58; P < 0.005), as well as improve heart failure questionnaire (Std. mean difference = 4.46; 95% CI = 3.44 to 5.47; P < 0.005), but had no influence on mortality (RR = 1.54; 95% CI = 0.80 to 2.96; P = 0.19) and quality of life questionnaire (Std. mean difference = 1.81; 95% CI = -0.14 to 3.77; P = 0.07).Compared with control intervention, palliative care intervention was found to significantly reduce readmission, ESAS, PHQ-9, and improve heart failure questionnaire, but showed no influence on mortality and quality of life questionnaire in patients with heart failure.