Aims: To investigate adherence and non‐adherence to treatment regimens among heart failure patients and to explore relationships with symptom burden and hospitalisation frequency.

Design: The research employed a cross‐sectional survey study design.

Methods: The online survey “Living with heart failure”, was conducted among patients attending the Cardiac outpatient clinic at a Swedish University Hospital over the course of a calendar year. Data analysis employed descriptive statistics using the statistical processing program SPSS.

Results: The survey was made accessible to 1395 respondents; 479 individuals participated. The response rate was 34.3%. 73.6% were classified as non‐adherent and 26.4% as adherent. Among the non‐adherent, a statistically significantly higher symptom burden was observed. Lower hospitalisation frequency was associated with higher adherence and lower symptom burden. Frequent hospitalisations correlated with lower adherence and more severe symptoms.

Conclusion/Implications: This study underscores the prevalence of non‐adherence in the heart failure population and emphasises the importance of addressing this issue.

Impact: Non‐adherence to treatment regimens remains a global challenge, historically underestimated and challenging to quantify. Non‐adherence to medical treatment in the heart failure population is about 50%; non‐adherence from a wider perspective implicates a gap of knowledge. The principal discoveries from this study underscore the extensive non‐adherence and its exacerbating effects on symptom burden and hospitalisation. The primary significance of this research will manifest among caregivers in multidisciplinary teams providing support to the heart failure population.

Reporting Method: The Equator Guidelines Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) were adhered to.

Patient or Public Contribution: No patient or public contribution.