Ni Zhao, Dardas Latefa, Wu Bei, Shaw Ryan
School of Nursing, Duke University, Durham, North Carolina, USA.
School of Nursing, The University of Jordan, Amman, Jordan.
Heart Asia. 2019 Jun 24;11(2):e011173. doi: 10.1136/heartasia-2018-011173. eCollection 2019.
In China, poor cardioprotective medication adherence is a key reason for the high mortality rate of coronary heart disease (CHD). The aims of this systematic review are to (1) describe and synthesise factors that influence medication adherence among Chinese people with CHD, (2) evaluate the current status of intervention studies, and (3) discuss directions of future research to improve medication adherence. A comprehensive search using PubMed, Cumulative Index to Nursing and Allied Health Literature, Embase, Scopus, Global Health and PsycINFO was undertaken to describe poor adherence in China. Thirty-three eligible articles were included in the study. The review shows that there are multiple contributing factors to poor medication adherence, including patients' sociodemographic characteristics, health status and medication characteristics. In addition, from patients' perspective, lack of medication-related knowledge, such as the name, function, dosage and frequency, contributes to poor adherence. From physicians' perspective, a gap exists between CHD secondary prevention guidelines and clinical practice in China. Follow-up phone calls, educational lectures, booklets and reminder cards were common methods found to be effective in improving medication adherence. This systematic review indicates that cardioprotective medications were commonly prescribed as secondary prevention medication to patients with CHD in China, but adherence to these medications gradually decreased during a follow-up period. Therefore, more research should be conducted on how to establish high-quality health educational programmes aimed at increasing patients' medication adherence.
在中国，心脏保护药物依从性差是冠心病（CHD）死亡率高的关键原因。本系统评价的目的是：（1）描述并综合影响中国冠心病患者药物依从性的因素；（2）评估干预研究的现状；（3）讨论未来提高药物依从性的研究方向。通过使用PubMed、护理学与健康相关文献累积索引、Embase、Scopus、全球健康数据库和PsycINFO进行全面检索，以描述中国的依从性差的情况。该研究纳入了33篇符合条件的文章。评价表明，药物依从性差有多种促成因素，包括患者的社会人口学特征、健康状况和药物特征。此外，从患者角度来看，缺乏与药物相关的知识，如名称、功能、剂量和服用频率，会导致依从性差。从医生角度来看，中国冠心病二级预防指南与临床实践之间存在差距。随访电话、教育讲座、宣传册和提醒卡是发现的有效提高药物依从性的常见方法。该系统评价表明，在中国，心脏保护药物通常作为二级预防药物开给冠心病患者，但在随访期间这些药物的依从性逐渐下降。因此，应开展更多关于如何建立旨在提高患者药物依从性的高质量健康教育项目的研究。
