El-Komy Fatma, Sahm Laura J, Byrne Stephen, Bermingham Margaret, O'Driscoll Michelle
Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, T12 YT20, Ireland.
Pharmacy Department, Mercy University Hospital, Grenville Place, Cork, Ireland.
Int J Clin Pharm. 2025 Jun 4. doi: 10.1007/s11096-025-01927-x.
Over three million people annually experience myocardial infarction (MI). As MI survival rates increase, so does the importance of secondary prevention medications. International guidelines recommend using several medications to prevent further morbidity.
To synthesise the qualitative literature on the facilitators and barriers faced by MI survivors and their families/caregivers regarding medication management and, thus, medication adherence post-discharge.
This systematic review was conducted and reported following the PRISMA-2020 guidelines. Five databases were searched from inception until the 13th of August 2024. The inclusion criteria were articles focused on people aged 18 years or older who experienced MI and were discharged from acute care settings to home settings, as well as caregivers of individuals who met the above-mentioned criteria. Qualitative and mixed-methods studies with qualitative elements were deemed eligible for inclusion. The theoretical domain framework was used to analyse the findings. The quality of the included studies was assessed using the JBI Critical Appraisal tool for qualitative research. The Confidence in the Evidence from the reviews of qualitative research approach was applied to assess confidence in qualitative evidence synthesis.
Of the 14,002 titles, 11,354 remained after duplicates were removed. Of the 234 full-text screenings, fifteen were included. A total of 533 people who experienced MI and 25 spouses from eight different countries were included. The most prominent facilitator that emerged was "beliefs about consequences", whilst "lack of knowledge" and "environmental context and resources" were the most prominent barriers to medication management reported.
Patients face multiple challenges that affect their medication adherence post-MI. These findings highlight important considerations for creating an individualised, tailored approach to enhance medication adherence post-MI.
PROSPERO CRD42023424844.
每年有超过三百万人经历心肌梗死（MI）。随着心肌梗死生存率的提高，二级预防药物的重要性也日益凸显。国际指南推荐使用多种药物来预防进一步的发病。
综合关于心肌梗死幸存者及其家人/照顾者在药物管理方面所面临的促进因素和障碍的定性文献，从而了解出院后药物依从性的情况。
本系统评价按照PRISMA - 2020指南进行并报告。从数据库建立之初至2024年8月13日，对五个数据库进行了检索。纳入标准为聚焦于18岁及以上经历心肌梗死且从急性护理机构出院回家的人群，以及符合上述标准的个体的照顾者。包含定性元素的定性和混合方法研究被视为符合纳入条件。采用理论领域框架对研究结果进行分析。使用JBI定性研究批判性评价工具评估纳入研究的质量。采用定性研究综述证据的信心方法评估对定性证据综合的信心。
在14,002个标题中，去除重复项后剩余11,354个。在234篇全文筛选中，15篇被纳入。共纳入来自八个不同国家的533名经历心肌梗死的患者和25名配偶。出现的最突出的促进因素是“对后果的信念”，而“知识缺乏”和“环境背景与资源”是报告的药物管理最突出的障碍。
患者在心肌梗死后面临多种影响其药物依从性的挑战。这些发现突出了在制定个性化、量身定制的方法以提高心肌梗死后药物依从性方面的重要考虑因素。
PROSPERO CRD42023424844
