MEDICATION ADHERENCE, LIFESTYLE BEHAVIOURS, AND PERCEIVED STRESS AMONG PATIENTS WITH HEART FAILURE ATTENDING A TERTIARY CARE HOSPITAL IN KARACHI: A CROSS-SECTIONAL STUDY
Abstract
Background:
Heart failure requires long-term medication adherence and appropriate lifestyle behaviours to support effective disease management and reduce the risk of adverse outcomes. However, medication non-adherence, physical inactivity, unhealthy dietary practices, sedentary behaviour, and psychological stress remain important challenges among patients with heart failure, particularly in settings where structured cardiac rehabilitation services are limited.
Objective:
To assess medication adherence, perceived stress, physical activity, dietary behaviours, and selected cardiovascular risk factors among patients with heart failure attending a tertiary care cardiac outpatient department in Karachi.
Methods:
A hospital-based cross-sectional study was conducted among 50 patients with heart failure aged 30–70 years. Participants were recruited using convenience sampling. Data were collected using the Medication Adherence Report Scale (MARS-5), Perceived Stress Scale (PSS-10), International Physical Activity Questionnaire-Short Form (IPAQ-SF), and selected WHO STEPS items. Descriptive statistics were used to summarize demographic, clinical, and behavioural characteristics. Continuous variables were presented as median and interquartile range (IQR).
Results:
The majority of participants were aged 61–70 years (40.0%) and male (70.0%). Hypertension was reported by 62.0%, while 50.0% had a family history of cardiac disease and 16.0% had undergone previous PCI. The median MARS-5 score was 22 (IQR: 21–24), while the median PSS-10 score was 21 (IQR: 18–24). Physical activity was low, with a median of 33 MET-min/week (IQR: 0–165), and median sitting time was 10 hours/day (IQR: 6.8–14). Median fruit and vegetable intake was 0.57 servings/day (IQR: 0.43–1), substantially below the recommended level. Current smoking was reported by 10.0% of participants.
Conclusion:
Patients with heart failure demonstrated several modifiable behavioural and psychosocial risk factors, including suboptimal physical activity, prolonged sedentary behaviour, inadequate fruit and vegetable intake, perceived stress, and less-than-optimal medication adherence. These findings support the need for structured, nurse-led education and cardiac rehabilitation strategies within routine heart failure care in Pakistan.
Keywords
- Heart failure; medication adherence; perceived stress; physical activity; dietary behaviour; cardiac rehabilitation; nurse-led care
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