Background: Congestive heart failure is a serious health threat, and poor adherence lowers patients' quality of life and increases disease burden. This study aimed to evaluate effect of instructional scheme on adherence to health recommendations among patients with congestive heart failure. Materials and Methods: A quasi-experimental design was used. A convenience sample of 100 patients in the outpatient cardiac clinic unit, 50 patients for the study group and 50 patients for the control group. Data were collected using a patient demographic and medical information questionnaire and the Medical Outcome Study Specific Adherence Scale (MOSSAS). The intervention was conducted over twelve weeks in ten sessions, from implementing the instructional scheme to the follow-up phase. Results: There was a significant improvement in the study group compared with the control group regarding adherence to taking medications as prescribed, monitoring weight regularly, a low salt diet, monitoring symptoms every day, a low-fat diet, stopping smoking, and exercising regularly with a P value <.001* and an effect size.63, .48, .47, .47, .35, .25, .14 respectively. Regarding total adherence, there was a significant improvement in the study group compared with the control group with F, df, P values, and effect size with values (142.19,4 (<.001). Conclusion: There was a statistically significant difference between study and control groups regarding total adherence after the implementation of the instructional scheme. Also, there was a statistically significant difference between the study and control group regarding adherence to all MOSSAS dimensions Recommendations: Instructional schemes for health recommendations should be regularly conducted.