Medication adherence and health-related quality of life among patients with heart failure: a cross-sectional study

BACKGROUND: Heart failure (HF) continues to be a significant public health concern. Adherence to guideline-directed medical therapy (GDMT) is essential for improving clinical outcomes and quality of life (QoL) in these patients. OBJECTIVES: This study aimed to evaluate how well patients with chronic HF adhere to GDMT and to assess their health-related QoL. METHODS: This cross-sectional study was conducted using data collected between March and May 2025. Eligible participants were adult outpatients with a confirmed diagnosis of HF who were able to complete the study questionnaires. Medication adherence was assessed using the 8-item Morisky Medication Adherence Scale (MMAS-8), while health-related QoL was evaluated with the Minnesota Living with Heart Failure Questionnaire. Data were analyzed using SPSS version 25, with statistical significance set at p < 0.05. RESULTS: Among 300 HF patients (64.7% male; median age of 63), sixty-nine percent had reduced ejection fraction (median EF 30%), with 62.4% classified as NYHA III or IV. Medication adherence was low in 25%, moderate in 44.6%, and high in 30.3%. Patients with more severe HF symptoms (higher NYHA class) reported significantly lower QoL, while higher adherence correlated significantly with better QoL. Older patients had a lower risk of low adherence, while intracardiac devices were linked to a higher risk. CONCLUSION: Despite GDMT's critical role in HF management, a notable proportion of patients demonstrated low adherence, which was associated with diminished QoL. Special attention and targeted interventions for high-risk groups, particularly patients with intracardiac devices, are imperative for enhancing outcomes.