What is the clinical evidence from this study?

Study design: Meta-Analysis. Population: heart failure (n=1030). Intervention: Symptom perception interventions (including symptom monitoring and symptom analysis) vs. Usual care. Primary outcome: Symptom perception (SMD 0.579, 95% CI 0.259 to 0.898, p=0.000).

What does this research mean for the field?

Symptom perception interventions significantly improve symptom perception, self-care, and quality of life in patients with heart failure, but do not reduce rehospitalization, emergency department visits, or mortality. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This study aims to evaluate the effectiveness of symptom perception interventions on clinical and quality of life outcomes in heart failure patients.

February 27, 2026SHILAP Revista de lepidopterología0 citationsOpen Access

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

WJWei JiaShihezi University GWGuangju WangSoochow University YLYing LiuShenyang Pharmaceutical University

Key Result

Symptom perception interventions significantly improved symptom perception with an SMD of 0.579 (95% CI 0.259 to 0.898, P = 0.000) in patients with heart failure.

Key Points

This study aims to evaluate the effectiveness of symptom perception interventions on clinical and quality of life outcomes in heart failure patients.
Systematic database search conducted in PubMed, Embase, Cochrane Library, and CINAHL
Inclusion of randomized controlled trials (RCTs) on symptom perception interventions in heart failure
Independent screening and data extraction by two reviewers
Risk of bias assessed using the ROB2 tool
Meta-analysis conducted using STATA 17.0
Eight studies with 1,030 heart failure patients were included.
Symptom perception interventions improved symptomatic perception (SMD: 0.579, P < 0.001) and self-care (SMD: 0.697, P < 0.001).
Interventions enhanced heart failure knowledge (SMD: 1.481, P = 0.017) and self-care efficacy (MD: 7.875, P = 0.024).
Quality of life was improved (MD: −8.240, P = 0.040), but rehospitalization, emergency visits, and mortality rates did not decrease.

Study Design

Type

Meta-Analysis (n=1,030)

Multicenter

Yes

Structured PICO

Do symptom perception interventions improve symptom perception and clinical outcomes in patients with heart failure?

Population

1,030 adult patients with a confirmed diagnosis of heart failure pooled from 8 RCTs. Mean age ranged from 55.0 to 79.0 years, 69.0% male. Disease severity included NYHA class I-IV.

Intervention

Symptom perception interventions involving both symptom monitoring (e.g., daily weight, symptom diaries, mobile apps) and symptom analysis (e.g., interpreting symptoms, recognizing worsening signs), delivered via face-to-face, telephone, or digital tools for durations ranging from 1 week to 8 months.

Comparator

Usual care

Outcome

Symptom perception (assessed at the earliest time point following intervention)patient reported

Symptom perception interventions improve patient-reported outcomes such as self-care, knowledge, and quality of life in heart failure patients, but do not reduce hard clinical events like rehospitalization or mortality.

Main Result

Effect estimate: SMD 0.579 (95% CI 0.259 to 0.898)

p-value: p=0.000

Limitations

High heterogeneity due to different measurement tools for symptom perception and self-care
Some included studies had moderate to high risk of bias
Lack of gold standard assessment tool for symptom perception
Symptom perception interventions were often integrated into larger self-care programs limiting isolated effect evaluation
Limited follow-up duration variability (1 to 12 months)

Abstract

Background 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). Methods 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. Results 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). Conclusion 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. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/view/CRD420251035486 , PROSPERO CRD420251035486.

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