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Cardioprotective medication adherence among patients with coronary heart disease in China: a systematic review
  1. Zhao Ni1,
  2. Latefa Dardas2,
  3. Bei Wu3,
  4. Ryan Shaw1
  1. 1School of Nursing, Duke University, Durham, North Carolina, USA
  2. 2School of Nursing, The University of Jordan, Amman, Jordan
  3. 3Rory Meyers College of Nursing, New York University, New York City, New York, USA
  1. Correspondence to Dr Zhao Ni, School of Nursing, Duke University, Durham, North Carolina, USA;{at}


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.

  • medication adherence
  • coronary heart disease
  • china
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  • Contributors All authors contributed to the conception and design of the study. ZN, LD and Dr. Ryan Shaw were responsible for the data acquisition and analysis. All authors contributed to data interpretation and to writing and approving the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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