title: Themes in the literature related to cardiovascular disease risk reduction.
abstract: OBJECTIVE
  This article aimed to identify themes in the literature related to patient-healthcare provider beliefs, barriers to adherence, and interventions pertaining to cardiovascular disease risk reduction.
  
  
  METHODS
  Twenty quantitative and qualitative primary research studies including 2 meta-analyses published between 1995 and 2008 were analyzed for themes and practice implications to synthesize existing research on cardiovascular disease risk reduction. Databases searched included EBSCO, CINAHL, MEDLINE, ScienceDirect, HealthSource, and PsychLit using the search terms patient- provider adherence, adherence and shared decision making, adherence and decision support, patient- provider goal setting, and cardiovascular disease risk reduction.
  
  
  RESULTS
  The emergent themes found in this literature review included (1) complex medication regimens; (2) risk perception, quality of life, and competing priorities; (3) motivation for change; (4) provider clinical inertia; and (5) goal setting, feedback, and reminders. Studies reporting the highest rates of adherence to cardiovascular disease risk reduction recommendations incorporated patient-provider goal setting and decision support, self-management techniques, and personalized printed communication.
  
  
  CONCLUSIONS
  Goal setting in cardiovascular disease risk reduction is a relatively unexplored area and is an important component of shared decision making and adherence to cardiovascular disease health recommendations. The following review will address the 5 themes identified in more detail and provide a basis for improved clinical practice.
authors.affiliation: University of Hawaii, Manoa, Honolulu, HI 96822, USA. scohen@hawaii.edu
authors.forename: Shannon Munro
authors.initials: SM
authors.lastname: Cohen
authors.forename: Merle
authors.initials: M
authors.lastname: Kataoka-Yahiro
mesh_terms: D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control*; D003299:Cooperative Behavior; D003661:Decision Support Techniques; D006040:Goals; D006801:Humans; D015201:Meta-Analysis as Topic; D009042:Motivation; D010349:Patient Compliance; D010358:Patient Participation; D011369:Professional-Patient Relations; D036301:Qualitative Research; D011788:Quality of Life; D017010:Reminder Systems; D012107:Research Design; D018570:Risk Assessment; D040242:Risk Reduction Behavior; D012648:Self Care / Q000379:methods / Q000523:psychology