Al Hamid A, Ghaleb M, Aljadhey H, Aslanpour Z
Department of Pharmacy, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, Hertfordshire, UK.
Medication Safety Research Chair, Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.
BMJ Open. 2014 Sep 19;4(9):e005992. doi: 10.1136/bmjopen-2014-005992.
To synthesise contributing factors leading to medicine-related problems (MRPs) in adult patients with cardiovascular diseases and/or diabetes mellitus from their perspectives.
A systematic literature review of qualitative studies regarding the contributory factors leading to MRPs, medication errors and non-adherence, followed by a thematic synthesis of the studies.
We screened Pubmed, EMBASE, ISI Web of Knowledge, PsycInfo, International Pharmaceutical Abstract and PsycExtra for qualitative studies (interviews, focus groups and questionnaires of a qualitative nature).
Thematic synthesis was achieved by coding and developing themes from the findings of qualitative studies.
The synthesis yielded 21 studies that satisfied the inclusion and exclusion criteria. Three themes emerged that involved contributing factors to MRPs: patient-related factors including socioeconomic factors (beliefs, feeling victimised, history of the condition, lack of finance, lack of motivation and low self-esteem) and lifestyle factors (diet, lack of exercise/time to see the doctor, obesity, smoking and stress), medicine-related factors (belief in natural remedies, fear of medicine, lack of belief in medicines, lack of knowledge, non-adherence and polypharmacy) and condition-related factors (lack of knowledge/understanding, fear of condition and its complications, and lack of control).
MRPs represent a major health threat, especially among adult patients with cardiovascular diseases and/or diabetes mellitus. The patients' perspectives uncovered hidden factors that could cause and/or contribute to MRPs in these groups of patients.
从成年心血管疾病和/或糖尿病患者的角度，综合导致药物相关问题（MRP）的影响因素。
对关于导致MRP、用药错误和不依从的影响因素的定性研究进行系统文献综述，随后对这些研究进行主题综合分析。
我们在PubMed、EMBASE、ISI Web of Knowledge、PsycInfo、国际药学文摘和PsycExtra中筛选定性研究（访谈、焦点小组和定性问卷）。
通过对定性研究结果进行编码和提炼主题来实现主题综合分析。
综合分析得出21项符合纳入和排除标准的研究。出现了三个涉及导致MRP的影响因素的主题：与患者相关的因素，包括社会经济因素（信念、感觉受伤害、疾病史、资金不足、缺乏动力和自尊心低）和生活方式因素（饮食、缺乏锻炼/看医生的时间、肥胖、吸烟和压力）；与药物相关的因素（相信天然疗法、害怕药物、对药物缺乏信心、知识缺乏、不依从和多重用药）；与疾病相关的因素（知识/理解缺乏、害怕疾病及其并发症、以及缺乏控制）。
MRP是一个重大的健康威胁，尤其是在成年心血管疾病和/或糖尿病患者中。患者的观点揭示了可能导致这些患者群体中MRP的隐藏因素。
