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Background Heart failure (HF) is a chronic syndrome where poor adherence undermines the benefits of pharmacological therapy. This study evaluated the ‘Making Medicines Work for You’ screener, a brief Capability, Opportunity, Motivation–Behaviour (COM-B) based tool used to identify adherence barriers in HF patients.Method A retrospective cross-sectional single-site study was conducted in outpatient community and hospital pharmacist and nurse-led HF outpatient clinics between January–November 2024. Statistical analysis was undertaken to identify associations (Chi-squared, Analysis of Variance (ANOVA)) and differences (post-Hoc Tukey) between patient and clinical factors.Results Of 500 patients assessed (median age 69 years, range 17–98), 44.2% (n=221) had at least one adherence related barrier. The most common barrier identified was forgetfulness (21.2%, n=106). Older patients were more likely to experience adherence related barriers (p=0.006). More barriers were reported during pharmacist consultations compared with nurse-led consultations (p<0.001).Conclusion The screener tool effectively identified adherence related barriers in patients. Screener responses may inform targeted, clinician-led interventions.