Depressive Symptoms and Treatment Adherence in Patients With Chronic Heart Failure Managed in Internal Medicine Clinics: Cross-Sectional Study

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Published: 2026-06-01
DOI: https://doi.org/10.61919/k504hs95
Keywords:
chronic heart failure; depressive symptoms; treatment adherence; medication compliance; dietary adherence; clinic follow-up; PHQ-9; internal medicine clinics; Pakistan.

Main Article Content

Rukia Kamal
MBBS, MRCPI (Internal Medicine), Registrar Internal Medicine, AlWisam Medical Care Complex AWMCC, Taif, Saudi Arabia
Ayesha Umar
MBBS, Medical Officer, Hearts International Hospital, Rawalpindi, Pakistan
Irfan Nawaz
Resident Adult Cardiology, MBBS, PLAB, Prince Sultan Cardiac Center Hassa PSCCH, Saudi Arabia
Aqsa Chachar
MBBS, Dow International Medical College, Karachi, Pakistan
Mariam Murtaza
MBBS Fourth Year, Dow University of Health Sciences, Karachi, Pakistan
Muhammad Rahman
MBBS, Wah Medical College, National University of Medical Sciences, Wah Cantt, Pakistan.
Huma Hassan
MBBS, Liaquat University of Medical & Health Sciences, Jamshoro, Pakistan.

Abstract

Background: Chronic heart failure requires sustained medication use, dietary self-care, and regular follow-up, but depressive symptoms may interfere with these behaviors and remain underrecognized in routine outpatient care. Objective: To assess the prevalence of depressive symptoms among patients with chronic heart failure attending internal medicine clinics and evaluate their association with treatment adherence. Methods: This cross-sectional observational study included 180 adult patients with chronic heart failure attending selected tertiary care hospitals in Rawalpindi, Pakistan. Depressive symptoms were assessed using the Patient Health Questionnaire-9, with a score of ≥10 defining clinically significant depressive symptoms. Treatment adherence was evaluated across medication compliance, dietary adherence, and clinic follow-up domains. Associations were assessed using chi-square testing, and odds ratios with 95% confidence intervals were calculated. Results: Clinically significant depressive symptoms were present in 76 patients (42.2%). Poor adherence was most frequent for dietary recommendations (51.1%), followed by medication compliance (42.2%) and clinic follow-up (32.8%). Patients with depressive symptoms had higher odds of poor medication adherence (OR 4.65, 95% CI 2.46–8.79; p<0.001), poor dietary adherence (OR 5.29, 95% CI 2.76–10.14; p<0.001), and poor clinic follow-up (OR 1.87, 95% CI 1.00–3.51; p=0.047). Poor adherence increased progressively with greater depressive symptom severity. Conclusion: Depressive symptoms were common and significantly associated with poorer treatment adherence among patients with chronic heart failure, particularly for dietary and medication-related self-care. Routine depressive symptom screening and integrated psychosocial support may improve outpatient heart failure management

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Vol. 4 No. 11 (2026): Volume 4, Issue 11 (June 2026)

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Articles
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This work is licensed under a Creative Commons Attribution 4.0 International License.

How to Cite

1.
Rukia Kamal, Ayesha Umar, Irfan Nawaz, Aqsa Chachar, Mariam Murtaza, Muhammad Rahman, et al. Depressive Symptoms and Treatment Adherence in Patients With Chronic Heart Failure Managed in Internal Medicine Clinics: Cross-Sectional Study. JHWCR [Internet]. 2026 Jun. 1 [cited 2026 Jun. 1];4(11):1-11. Available from: https://jhwcr.com/index.php/jhwcr/article/view/1664

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