Objective To evaluate stress, depression and quality of life among community-dwelling patients with heart failure (HF) and evaluate their effect on perceived medication adherence in a socioeconomically challenged setting. Design A cross-sectional design with self-administered questionnaire with data collected between October 2021 and September 2022. Methods Patients with confirmed diagnosis of HF were sought for data collection in the community and cardiology clinics through an electronic platform. Confirmation of cases was done through the ejection fraction, medication list and frequent symptoms of the patients. The Patient Health Questionnaire-9, the COVID-19 Stress Scale, the Minnesota Living with HF Questionnaire and the Lebanese Medication Adherence Scale were used to evaluate depression, stress, quality of life and medication adherence, respectively. Univariate analysis was done to present the descriptive statistics, whereas bivariate and multivariate analyses were done to evaluate the relationship between the variables. Results A total of 237 participants were included in the final analysis. The mean age was 61.3±17.36 years, and the majority (57.8%) were male participants. Only 44.7% were on ACE inhibitors/angiotensin receptor blockers and 54.9% on beta-blockers. The mean scores for stress, depression, quality of life and medication adherence were 75.86 (SD=24.5), 14.03 (SD=5.7), 55.73 (SD=23.05) and 6.79 (SD=6.93), respectively, indicating high stress levels, depression, poor quality of life and medication adherence. Those with a history of hypertension and depression were significantly more adherent to their medications than those who were not. Multivariate analysis showed that anxiety, medical follow-up, quality of life and functionality class were predictors of medication adherence. Conclusion The study showed the population with HF in Lebanon to have psychological health problems with these variables acting as predictors for medication adherence. Sociodemographic characteristics also played a role on the outcome, which can be targeted when planning interventions to improve outcomes. Future studies should compare prescribed medication with consumed medication through longitudinal approaches and medical refilling techniques when possible. Data are available upon reasonable request. Raw data will be available upon request.

中文翻译：

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社会经济挑战下心力衰竭患者的心理社会因素对药物依从性的影响

目的 评估社区心力衰竭 (HF) 患者的压力、抑郁和生活质量，并评估其在社会经济困难环境中对药物依从性的影响。设计 采用自填式问卷横断面设计，收集 2021 年 10 月至 2022 年 9 月期间收集的数据。方法 通过电子平台在社区和心脏病诊所寻找确诊为心力衰竭的患者，进行数据收集。通过射血分数、药物清单和患者的常见症状来确认病例。患者健康问卷 9、COVID-19 压力量表、明尼苏达心衰患者问卷和黎巴嫩药物依从性量表分别用于评估抑郁、压力、生活质量和药物依从性。进行单变量分析是为了提供描述性统计数据，而进行双变量和多变量分析是为了评估变量之间的关系。结果 共有237名参与者进入最终分析。平均年龄为61.3±17.36岁，大多数（57.8%）是男性参与者。只有 44.7% 的人服用 ACE 抑制剂/血管紧张素受体阻滞剂，54.9% 的人服用 β 受体阻滞剂。压力、抑郁、生活质量和药物依从性的平均得分分别为 75.86 (SD=24.5)、14.03 (SD=5.7)、55.73 (SD=23.05) 和 6.79 (SD=6.93)，表明压力水平较高，抑郁、生活质量差和药物依从性。有高血压和抑郁症病史的人比没有高血压和抑郁症病史的人对药物的依从性明显更高。多变量分析表明，焦虑、医疗随访、生活质量和功能等级是药物依从性的预测因素。结论 研究表明，黎巴嫩心衰人群存在心理健康问题，这些变量可作为药物依从性的预测因素。社会人口特征也对结果产生影响，在规划干预措施以改善结果时可以有针对性地进行。未来的研究应尽可能通过纵向方法和医疗补充技术来比较处方药物和消耗药物。数据可根据合理要求提供。原始数据将根据要求提供。