Medication non-adherence among heart failure patients: a multi-hospital, multi-dimensional analytical study in Punjab, Pakistan.
12 affiliations
- 1Department of community Medicine, Baqai Medical College, Baqai Medical University, Karachi, Pakistan.
- 2Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
- 3Center for Drug Safety and Policy Research, Xian Jiaotong University, Xi'an, Shaanxi, China.
- 4Department of Gynaecology and Obstetrics, Punjab Employees Social Security Institute, Lahore, Pakistan.
- 5Department of Community Medicine, Sheikh Zayed Medical College, Rahim Yar Khan, Pakistan.
- 6Department of Medicine, Services Hospital, Medical unit 1, Lahore, Pakistan.
- 7Faculty of Health Management Sciences, Baqai Medical University, Karachi, Pakistan.
- 8Preventive Dental Sciences Department, College of Dentistry, King Faisal University, Hofuf, Al-Ahsa, 31982, Saudi Arabia.
- 9Green International University, Lahore, Pakistan.
- 10Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Center for Drug Safety and Policy Research, Xi'an Jiaotong University, Xi'an Jiaotong University, 76 Yanta West Road Xi'an, People, 710061, China.
- 11Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi'an Jiaotong University, Xi'an, Shaanxi, China. [email protected].
- 12Center for Drug Safety and Policy Research, Xian Jiaotong University, Xi'an, Shaanxi, China. [email protected].
Abstract
Background
Heart failure (HF) has been a significant health problem among the population, with a significant impact on morbidity, mortality, and health care expenditure across the world. In Pakistan, HF-specific non-adherence data are limited, which restricts clinicians to come up with interventions that can be used to address the at-risk population. Accordingly, the newly-conducted study intended to determine the incidence of medication non-adherence and predictors at various levels (sociodemographic, clinical, treatment-related, and behavioral) among heart failure patients.Methods
This survey was a cross-sectional questionnaire survey among 9,377 eligible patients between January 2024 and April 2025 in 20 public and private healthcare facilities across Punjab, Pakistan. The primary outcome was non-adherence to medications assessed through the Self-Efficacy for Appropriate Medication Scale (SEAMS) and self-reported number of pills. Study variables were summarized using descriptive statistics. Chi-square/Fisher's exact test, independent t-test/ANOVA, and a generalized linear model (GLM) with a logit link function (multivariable logistic regression) were employed to assess associations with demographic characteristics. Seaborn and Matplotlib were used to create a heatmap and an odds ratio plot, respectively.Results
Non-adherence to medication is alarmingly prevalent among heart failure (Hf) patients in Punjab, Pakistan (50.1%), and the mean SEAMS score was 31.65 ± 7.69, indicating moderate to high levels of self-efficacy in medication-taking behavior. Socio-demographic predictors including female gender (AOR = 1.415, 95% CI: 1.039 - 1.926), primary and secondary education (AOR = 1.285, 95% CI: 1.074-1.481), monthly income 10,000-25000 (AOR = 1.292, 95% CI: 0.616-0.993), no health insurance (AOR = 1.276, 95% CI: 1.138-1.430) had increased odds of non-adherence. Clinical and health-related predictors such as the presence of comorbidities, especially diabetes (AOR = 1.164, 95% CI: 1.0511.428), and non-hospitalized patients (AOR = 1.236, 95% CI: 1.122-1.362).Conclusion
Non-adherence to medication is extremely common in heart failure patients and depends on various sociodemographic, clinical, and behavioral factors. Specific interventions to deal with these determinants can aid in improving adherence and clinical outcomes.
Related
- Adherence of HIV/AIDS patients following Medication Therapy Management and Pharmacist Counselling at a Public Hospital in Yogyakarta, Indonesia
- Medication Adherence in Patients With Glaucoma and Determinants of Treatment Adherence: A Cross-Sectional Study
- The impact of attachment styles and self-compassion on medication adherence in breast cancer patients: A cross-sectional study
- Pathways to medication adherence: a configurational analysis of psychiatric symptoms and medication attitude in patients with schizophrenia spectrum disorder receiving long-acting injectable antipsychotics.
- Medication adherence among patients with psychiatric illness: Role of internalized stigma
BibTeX
@article{arshed2026medication,
title = {{Medication non-adherence among heart failure patients: a multi-hospital, multi-dimensional analytical study in Punjab, Pakistan.}},
author = {Muhammad Arshed and Hafsa Arshad and Mehwish Kiran and Hina Lateef and Syed Mehmood Ul Hassan and Syed Muhammad Fauzan Ali and Muhammad Farooq Umer and Javeria Saleem and Ali Hassan Gillani and Ali Jawa and Yu Fang},
journal = {BMC cardiovascular disorders},
year = {2026},
month = jul,
doi = {10.1186/s12872-026-06142-8},
url = {https://europepmc.org/article/MED/42894117},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Medication non-adherence among heart failure patients: a multi-hospital, multi-dimensional analytical study in Punjab, Pakistan.
AU - Muhammad Arshed
AU - Hafsa Arshad
AU - Mehwish Kiran
AU - Hina Lateef
AU - Syed Mehmood Ul Hassan
AU - Syed Muhammad Fauzan Ali
AU - Muhammad Farooq Umer
AU - Javeria Saleem
AU - Ali Hassan Gillani
AU - Ali Jawa
AU - Yu Fang
PY - 2026
DA - 2026/07/01
JO - BMC cardiovascular disorders
DO - 10.1186/s12872-026-06142-8
UR - https://europepmc.org/article/MED/42894117
AB - Background Heart failure (HF) has been a significant health problem among the population, with a significant impact on morbidity, mortality, and health care expenditure across the world. In Pakistan, HF-specific non-adherence data are limited, which restricts clinicians to come up with interventions that can be used to address the at-risk population. Accordingly, the newly-conducted study intended to determine the incidence of medication non-adherence and predictors at various levels (sociodemographic, clinical, treatment-related, and behavioral) among heart failure patients.Methods This survey was a cross-sectional questionnaire survey among 9,377 eligible patients between January 2024 and April 2025 in 20 public and private healthcare facilities across Punjab, Pakistan. The primary outcome was non-adherence to medications assessed through the Self-Efficacy for Appropriate Medication Scale (SEAMS) and self-reported number of pills. Study variables were summarized using descriptive statistics. Chi-square/Fisher's exact test, independent t-test/ANOVA, and a generalized linear model (GLM) with a logit link function (multivariable logistic regression) were employed to assess associations with demographic characteristics. Seaborn and Matplotlib were used to create a heatmap and an odds ratio plot, respectively.Results Non-adherence to medication is alarmingly prevalent among heart failure (Hf) patients in Punjab, Pakistan (50.1%), and the mean SEAMS score was 31.65 ± 7.69, indicating moderate to high levels of self-efficacy in medication-taking behavior. Socio-demographic predictors including female gender (AOR = 1.415, 95% CI: 1.039 - 1.926), primary and secondary education (AOR = 1.285, 95% CI: 1.074-1.481), monthly income 10,000-25000 (AOR = 1.292, 95% CI: 0.616-0.993), no health insurance (AOR = 1.276, 95% CI: 1.138-1.430) had increased odds of non-adherence. Clinical and health-related predictors such as the presence of comorbidities, especially diabetes (AOR = 1.164, 95% CI: 1.0511.428), and non-hospitalized patients (AOR = 1.236, 95% CI: 1.122-1.362).Conclusion Non-adherence to medication is extremely common in heart failure patients and depends on various sociodemographic, clinical, and behavioral factors. Specific interventions to deal with these determinants can aid in improving adherence and clinical outcomes.
SN - 1471-2261
ER -