NDLI: Medication taking in coronary artery disease: a systematic review and qualitative synthesis.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Rashid, Mohammed A. Edwards, Duncan Walter, Fiona M. Mant, Jonathan
Description	Country affiliation: United kingdom Author Affiliation: Rashid MA ( The Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Worts Causeway, Cambridge, United Kingdom.)
Abstract	PURPOSE: Despite the compelling evidence supporting cardiovascular medications in the secondary prevention of coronary artery disease, many patients discontinue treatment. In this synthesis, we sought to understand from a patient perspective the factors that promote medication persistence. METHODS: We systematically searched 7 databases (MEDLINE, Embase, PsycINFO, SCOPUS, CINAHL, ASSIA, and SSCI) for published qualitative research about the medication-taking experiences of patients with coronary artery disease and their partners. Articles were assessed for quality using a modified CASP (Critical Appraisal Skills Programme) checklist. Synthesis was undertaken using well-established meta-ethnographic approaches. RESULTS: We included 17 articles in the final synthesis from the United Kingdom (6), Europe (5), United States (4), China (1), and Australia (1), with a total sample size of 391 patients. Analyses suggested that some patients hold fatalistic beliefs about their disease, whereas others believe they have been cured by interventions; both can lead to failure to take medication. Patients who adapt to being a 'heart patient' are positive about medication taking. Some individuals dislike taking tablets generally and are wary of long-term effects. Relationships with prescribing clinicians are of critical importance for patients, with inaccessibility and insensitive terminology negatively affecting patients' perceptions about treatments. CONCLUSIONS: Strategies to promote higher persistence of secondary prevention medications in patients with coronary artery disease need to recognize the key role of the prescribing clinician. Providing medication-specific information at the time of initiating therapy, improving the transition between secondary and primary care, and explaining the risk of disease recurrence may all help to modify patient attitudes toward drugs to prevent further cardiovascular disease.
File Format	HTM / HTML
ISSN	15441709
e-ISSN	15441717
DOI	10.1370/afm.1620
Journal	The Annals of Family Medicine
Issue Number	3
Volume Number	12
Language	English
Publisher	Annals of Family Medicine Inc
Publisher Date	2014-05-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Family Medicine Coronary Artery Disease Drug Therapy Medication Adherence Attitude To Health Psychology Health Knowledge, Attitudes, Practice Statistics & Numerical Data Physician-patient Relations Secondary Prevention Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Family Practice

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