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Barriers and facilitators to medication adherence in patients after PCI surgery: A mixed-methods systematic review
Yong Fang1, Zhili Jiang2, Zhihao Han3
1Changsha Medical University, Changsha, China.
Background:
Patients after Percutaneous coronary intervention (PCI) should adhere to evidence-based medications to relieve symptoms and prevent cardiovascular events. However, the factors affecting patient medication adherence remain unclear.
Objectives:
To systematically synthesize the quantitative and qualitative evidence on the barriers and facilitators to medication adherence in patients after PCI surgery.
Methods:
A systematic search of the literature on the barriers and facilitators to medication adherence in patients after PCI surgery was performed in English and Chinese databases, including PubMed, Embase, CINAHL, Web of Science, CNKI, Wanfang and CBM, from inception to March 1, 2023. Retrieved studies were screened based on inclusion and exclusion criteria. Two researchers independently performed data extraction and quality assessment. The analysis of the barriers and facilitators to medication adherence in patients was based on the six sub-components of the Capability, Opportunity, and Motivation model of Behavior (COM-B) model, a behavioral science framework. The systematic review was registered on PROSPERO (CRD42022338400).
Results:
A total of 15 studies were included in the review. There were 31 factors identified that influenced medication adherence in patients after PCI surgery. Among these factors, 14 served as facilitators while 17 acted as barriers. All identified factors were subsequently mapped onto the six sub-components of the COM-B model.
Conclusion:
Identification of the barriers and facilitators to medication adherence within the six categories of the COM-B model in patients undergoing PCI can serve as a foundation for developing intervention strategies. These strategies should target the identified factors across the COM-B model. A comprehensive approach will improve medication adherence among PCI patients.
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