A systematic review and meta-analysis published in the American Journal of Hospice and Palliative Care assessed the impact of palliative care (PC) in heart failure (HF), incorporating recent randomized controlled trials (RCTs) to address gaps in prior non-HF-specific analyses. Electronic databases, including PubMed, EMBASE, CENTRAL, and CINAHL, were searched up to January 24, 2025 (PROSPERO ID: CRD42024607104). Eligible studies included RCTs evaluating PC interventions in HF populations.

The primary endpoint was hospitalization, while secondary outcomes included changes in quality of life (QoL), measured using Kansas City Cardiomyopathy Questionnaire (KCCQ) and Functional Assessment of Chronic Illness Therapy–Palliative Care (FACIT-Pal), and mental health assessed using Hospital Anxiety and Depression Scale (HADS).

A total of 21 RCTs were identified, with 13 studies (n=1919) included in quantitative synthesis. PC was associated with a reduction in hospitalization (log OR −0.6; 95% CI −1.14 to −0.07; I²=69%). Improvements were observed in QoL, with a mean difference (MD) in KCCQ of 3.09 (95% CI 1.43 to 4.75; I²=35%), and in depressive symptoms (HADS-D MD −0.44; 95% CI −0.75 to −0.13). No consistent differences were identified across intervention delivery modes. 

Subgroup analyses indicated that interventions exceeding 12 weeks duration were linked to greater QoL improvement, while studies with ≥70% participants in New York Heart Association (NYHA) class III/IV demonstrated larger reductions in hospitalization. No outcome variation was observed based on gender distribution.

Overall, PC was associated with improved clinical and patient-reported outcomes in HF. Longer duration and advanced symptom targeting were linked to greater benefit.