Prevalence of depression and its association with health-related quality of life in people with heart failure in low- and middle-income countries: a protocol for systematic review

Background Heart failure is a serious clinical burden with variety of physical and emotional symptoms such as fatigue, reduced functional capacity, edema, dyspnea and depression. These symptoms limit patients’ daily physical and social activities, which reduce their health-related quality of life. The objective of this systematic review is to estimate the prevalence of depression and its association with HRQoL in people living with heart failure in LMICs. Methods The primary outcome is the prevalence of depression in people with heart failure. The secondary outcome is association of depression with health-related quality of life. Comprehensive search of MEDLINE, PsycINFO, EMBASE, CINAHL, Web of Science, Scopus and JBI EBP databases will be conducted to identify relevant studies. The methodological quality of each article will be assessed using a JBI critical appraisal instruments. A random-effects model using the DerSimonian and Laird method will be employed to estimate the regional prevalence. Heterogeneity across the studies will be assessed by Cochrane Q test and I2 statistic. A funnel plot and Egger’ s test will be used for assessing publication bias. This protocol is developed in accordance with the JBI methodology for systematic reviews. All statistical analyses will be performed using STATA version 17 software. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines 2020 will be followed for reporting the results. Discussion This systematic review will provide up-to-date high-quality evidence on the impact of depression and inform healthcare policymakers on effective ways to improve care for this population in LMICs. The results will be published in a peer-reviewed journal. Systematic review registration PROSPERO CRD42022361759. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement There is no funding for this systematic review. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The study will used data from published studies I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes All the data are available from the corresponding author up on a reasonable request. * CVD : Cardiovascular diseases; HF : Heart failure; HRQoL : Health-related quality of life, JBI : Joanna Briggs Institute; LMICs : Low and middle income countries; PRISMA : Preferred Reporting Items for Systematic reviews and Meta-Analyses