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Up to 70% of patients near the end of their lives experience dyspnea, a common and upsetting symptom of advanced disease. Fan therapy is a straightforward nonpharmacologic intervention that may provide symptom relief, although trial results have been mixed. To address this uncertainty, we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs), including both parallel-group and crossover designs, evaluating face-directed fan therapy in adults with advanced disease, such as advanced cancer, COPD, interstitial lung disease, or heart failure.

We searched PubMed, Embase, and Cochrane CENTRAL from inception to August 2025 for RCTs evaluating face-directed fan therapy in adults with advanced disease. Eligible comparators included sham interventions, usual care, or no intervention. Primary outcome was change in dyspnea severity scores; secondary outcomes included breathing frequency and oxygen saturation. Random-effects meta-analysis was used to calculate standardized mean differences (SMDs) with 95% CIs.

Twelve RCTs with 463 subjects were included. Fan therapy significantly reduced immediate dyspnea compared with control (SMD = -1.33, 95% CI -2.12 to -0.53, P = .001), although heterogeneity was high (I² = 91%). No statistically significant benefit was observed for cumulative short-term dyspnea (SMD = -0.10, 95% CI -0.41 to 0.21, P = .53), breathing frequency (SMD = -0.73, 95% CI -1.81 to 0.36, P = .19), or oxygen saturation (SMD = 0.44, 95% CI -0.21 to 1.08, P = .19).

In subjects with advanced disease, fan therapy is a safe, affordable, and well-tolerated intervention that quickly relieves dyspnea, especially in supportive and palliative care settings. Larger, multi-center RCTs with standardized outcomes are necessary to elucidate sustained effects, as its long-term benefits are still unclear.