Palliative care in heart failure A meta-analysis of randomized controlled trials

Background Palliative care can play an important role in the management of heart failure. We conducted a systematic review and meta-analysis to compare the efficacy and safety of palliative care in patients with heart failure. Methods PubMed, Embase, Web of Science, EBSCO, and the Cochrane Library databases were systematically searched. Randomized controlled trials (RCTs) on the impact of palliative care on heart failure were included. Two investigators independently searched the articles, extracted data, and assessed the quality of included studies. The primary outcome was mortality. Results Seven RCTs were included in the meta-analysis. Compared with usual care for heart failure, palliative care was associated with a significantly increased quality of life (standardized mean difference= 1.46; 95% confidence interval [CI]= 0.12 to 2.79; p= 0.03) and reduced depression scores (standardized mean difference= -0.62; 95% CI= -0.99 to -0.25; p= 0.03), but demonstrated no impact on mortality (risk ratio [RR]= 1.28; 95% CI= 0.86 to 1.92; p= 0.22) and rehospitalization (RR= 0.84; 95% CI= 0.66 to 1.07; p= 0.16). Conclusion Palliative care can improve the quality of life and reduce the occurrence of depression in patients with heart failure.