# Effectiveness of symptom perception interventions among patients with heart failure: a systematic review and meta-analysis

## TL;DR

A review of 8 studies found that symptom perception interventions improve heart failure patients' self-care and quality of life but do not reduce hospitalizations or deaths.

## Contribution

This is the first meta-analysis quantitatively evaluating the impact of symptom perception interventions on multiple outcomes in heart failure patients.

## Key findings

- Symptom perception interventions significantly improved patients' symptom perception, self-care, and HF knowledge.
- The interventions enhanced self-care efficacy and quality of life but did not reduce rehospitalization or mortality.
- Eight studies with 1030 patients were analyzed to assess clinical and quality-of-life outcomes.

## Abstract

Although symptom perception appears promising for enhancing health-related quality of life in patients with heart failure (HF), no quantitative pooling of effect sizes has been described to summarize and test its efficacy on clinical outcomes. This systematic review and meta-analysis aimed to determine the effect of symptom perception interventions on HF patients’ symptom perception (primary outcome), self-care, HF knowledge, self-care efficacy, quality of life, rehospitalisation, emergency department visits, and mortality (secondary outcomes).

We systematically searched four databases: PubMed, Embase, the Cochrane Library, and CINAHL, from inception to March 31, 2025. RCT studies exploring the effectiveness of symptom perception interventions among HF patients were included. The studies were independently screened and extracted by two reviewers. ROB2 was applied to assess risk bias. A meta-analysis was performed using STATA 17.0.

Eight articles involving a total of 1030 patients were included. Pooled results showed that for HF patients, symptom perception interventions failed to decrease rehospitalization, emergency department visits and mortality. However, such interventions significantly improved patients’ immediate post-intervention outcomes, including symptom perception (SMD: 0.579, 95% CI: 0.259–0.898, P = 0.000), self-care (SMD: 0.697, 95% CI: 0.436–0.959, P = 0.000), HF knowledge (SMD: 1.481, 95% CI: 0.270–2.692, P = 0.017), self-care efficacy (MD: 7.875, 95% CI: 1.054–14.695, P = 0.024), and ultimately enhanced quality of life (MD: −8.240, 95% CI: −16.088 to −0.392, P = 0.040).

The review suggests that symptom perception interventions can improve HF patients’ symptom perception, self-care, HF knowledge, self-care efficacy, and quality of life, although they do not reduce rehospitalization, emergency department visits, or mortality. The findings provide a basis for optimizing symptom perception intervention plans for future researchers.

https://www.crd.york.ac.uk/PROSPERO/view/CRD420251035486, PROSPERO CRD420251035486.