Impact of psychological factors on treatment adherence in patients with heart failure

Introduction

Treatment adherence in patients with heart failure may be affected by psychological risk factors such as anxiety, depression and stress, altering emotional and cognitive functioning and interfering with health care behaviours. Depression is associated with lower active participation in treatment, while anxiety and stress influence adherence.

Purpose

To evaluate the correlation between treatment adherence, anxiety, depression and perceived stress in patients with heart failure.

Methodology

An observational, descriptive, cross-sectional study was conducted. The sample consisted of 107 patients with heart failure, selected through non-probabilistic convenience sampling.

Treatment adherence was assessed using the MGB scale, while depressive symptomatology was measured using the Patient Health Questionnaire-9 (PHQ-9), anxiety symptomatology using the Generalized Anxiety Disorder-7 (GAD-7), and perceived stress (PS) using the Perceived Stress Scale.

Data analysis was performed using the JASP software. Spearman correlations were applied for data analysis. Additionally, a multiple linear regression model was conducted to identify the joint contribution of psychological variables to treatment adherence. The level of statistical significance was set at p < .05.

Results

The mean age of the patients was 64.05 ± 13.31 years. The sample was predominantly male (50.9%). The analysis showed a strong positive correlation between anxiety and depression (ρ = 0.639, p < .001), as well as moderate positive associations between perceived stress and anxiety (ρ = 0.523) and depression (ρ = 0.417).

Treatment adherence showed a significant negative correlation with depression (ρ = –0.276, p = .004), with no significant associations with anxiety or stress.

The regression model (F(3, 764) = , p < .001, R² = 0.887), which includes stress, anxiety and depression, explained 88.7% of the total variance of the model, over other clinical and psychological variables adjusted for age and sex.

Conclusions

The findings suggest that depression is the psychological factor with the greatest direct impact on treatment adherence in patients with heart failure, while anxiety and stress influence adherence indirectly through their association with depressive symptoms. The identification and timely management of anxiety, depression and stress could promote better therapeutic adherence and potentially improve clinical outcomes in this population.