BACKGROUND: Health systems increasingly recognise palliative care as an essential component of universal health coverage. Assessing palliative care quality and value remains challenging, as key outcomes are often missed by routine indicators. Patient-reported outcome measures (PROMs) can address this gap, but their use remains fragmented. OBJECTIVE: To synthesise evidence on patient-reported outcomes in palliative care, the PROMs used to measure them, and implementation barriers and facilitators. METHODS: Five databases (PubMed, Web of Science, Scopus, CINAHL, and the Cochrane Library were searched between 1989 and December 2025, following PRISMA guidelines. Studies focusing on PROM use in palliative care were included. Data were analysed to map outcome domains, commonly used instruments, and implementation barriers and facilitators. Study quality was assessed using Joanna Briggs Institute critical appraisal checklists. RESULTS: Seventy studies were included. Most were conducted in high- and middle-income countries and focused on patients with cancer. Physical, psychological, social, spiritual and quality-of-life outcomes were most frequently assessed. The most commonly used PROMs were the Integrated Palliative Care Outcome Scale (IPOS), Edmonton Symptom Assessment Scale (ESAS), and the EORTC QLQ-C15-PAL instrument. Implementation challenges included patient frailty, workload and time constraints, limited standardisation, and poor integration into clinical workflows and health information systems. Heterogeneity across populations, settings, and PROMs limited comparability. CONCLUSIONS: The findings provide practical guidance for health systems seeking to integrate PROMs into palliative care and support patient-centred quality monitoring and service evaluation. Greater standardisation, digital integration, and policy support are needed to strengthen service development, quality improvement, and health system accountability.

BACKGROUND/OBJECTIVES: Rapid advancements in reperfusion strategies and optimized medical therapies have significantly improved survival among patients with acute coronary syndromes (ACS). However, a large population still lives with the chronic consequences of the disease, including impaired post-discharge health-related quality of life (HRQOL). This systematic review aimed to identify and summarize the existing evidence regarding the determinants of HRQOL among patients with ACS. METHODS: A comprehensive search following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was performed in PubMed, Scopus, Web of Science and Science Direct until 20 July 2025. The review protocol was registered with PROSPERO (ID CRD420251157478). RESULTS: From an initial 12,280 articles, 55 were selected. Forty-two studies used a cohort design and thirteen were cross-sectional. All studies were published between 2000 and 2025. Most of the studies were conducted in Europe and America. Common predictors of improved HRQOL were better baseline quality of life, previous exercise behavior, sense of coherence, coping strategies, revascularization during index hospitalization, time passed after ACS and diagnosis of STEMI. The most common factors that worsened HRQOL were female sex, lower educational and financial status, being unemployed, depression, anxiety, the presence of comorbidities and lower social support including having no partner. CONCLUSIONS: The findings highlight that post-ACS HRQOL is determined by multiple factors including demographic, clinical and psychological factors. Clinical practice should therefore focus on targeted strategies that optimize modifiable factors, prioritizing early psychological screening and individualized support for high-risk groups, to effectively improve HRQOL and overall quality of care.