Medication non-adherence leads to recurrent admissions, worsening symptoms, poor quality of life, and increased healthcare costs in an already overburdened health system. Existing adherence interventions in Pakistan are limited, mostly educational, and rarely guided by behavioural theory, implementation science, or economic evaluation.
Therefore, a culturally appropriate, RE-AIM-informed autonomy-competence intervention is needed to improve medication adherence and quality of life among heart failure patients in Pakistan, while also assessing implementation feasibility and cost-effectiveness for future scale-up.
Age ≥18 years
Diagnosed heart failure for at least 6 months
Prescribed ≥2 heart failure medications
Documented medication non-adherence
Severe psychiatric illness
Terminal illness
Severe cognitive impairment
End-stage renal disease