Disgraced celebrity publicist Max Clifford did not always take his medication at the “correct doses, if at all” before he died of heart failure, a prison doctor has told an inquest.

Clifford, 74, collapsed at Littlehey prison in Cambridgeshire, where he was serving an eight-year sentence for historical sex offences. He died at Hinchingbrooke hospital near Huntingdon on 10 December 2017. Dr Monica Chambers, who works as a GP at the prison, told an inquest in Peterborough: “Mr Clifford wasn’t always taking his medications at the correct doses, if at all.”

She said: “Prisoners are the same as the rest of the population. Many people hate taking tablets, many people are wary of taking tablets, many people do not like the side-effects.” She did not comment on whether this would have affected Clifford’s health.

Asked about the quality of the prison’s healthcare by Kimberley Aiken-Barre, representing Clifford’s family, Chambers said: “I think that our sick patients get a much better standard of healthcare than anybody does on the outside.” Asked further about conditions for Clifford, she said: “I believe Mr Clifford had a superb mattress, a very comfortable mattress, I don’t know how he managed to get that.”

GPs visit the prison weekly, she said, with prisoners allocated the same doctor each week for continuity.

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Clifford first reported shortness of breath on 26 July 2017, she told Monday’s hearing, and was referred to a cardiologist at Hinchingbrooke after analysis of his blood samples.

The hospital wrote to the prison to say it had established that his “heart failure came on gradually; there wasn’t a sudden event”, and embarked on further investigations, Chambers said. He was prescribed drugs including to prevent his heart from going into an abnormal rhythm, she said.

A diagnosis of cardiac AL amyloidosis – a rare, serious condition caused by a build-up of abnormal proteins in organs and tissues – was reached by 6 December after Clifford was referred to a gastroenterologist, the inquest heard. It came after he had complained of further symptoms including “increased lethargy”, Dr Chambers added.

She said she referred Clifford to hospital on 8 December 8 2017 after colleagues raised concerns about his health and she visited him in his cell, as he was too unwell to go to the prison’s healthcare unit.

“He said he had fallen whilst in the shower that morning,” she said. “I noticed his blood pressure was low.”

She said he was short of breath and needed help to put his trousers on before an ambulance took him to hospital, where he died two days later. A postmortem examination recorded his cause of death as congestive heart failure.

Further underlying factors were given as cardiac AL amyloidosis, and plasma cell neoplasm, in which the body makes too many plasma cells.

Simon Milburn, assistant coroner for Cambridgeshire, said during the opening of the hearing that Clifford’s death “could not have been prevented” but that the inquest would examine “whether there were missed opportunities to provide an earlier diagnosis”. Dr Chambers said Clifford had missed one hospital appointment, which he had been told about at short notice, as it clashed with an appointment to see his legal team.

She said details of hospital appointments could not be given to prisoners far in advance, adding: “It’s one of the most frequent ways of escaping from prison so they’re told at late notice.”

Milburn said a cardiac MRI had been considered for Clifford but that “he didn’t feel he could tolerate the claustrophobia of the MRI tunnel” .

Aiken-Barre attempted to ask a witness, another prison GP, about the impact of a lack of heating in Clifford’s cell. Milburn halted the line of questioning, telling her: “I’m struggling to see the evidence or the relevance of this.” Clifford’s family had previously said he had complained of cold showers in prison.

The hearing, scheduled for five days, continues.