title: A systematic review of qualitative research on the contributory factors leading to medicine-related problems from the perspectives of adult patients with cardiovascular diseases and diabetes mellitus.
abstract: OBJECTIVE
  To synthesise contributing factors leading to medicine-related problems (MRPs) in adult patients with cardiovascular diseases and/or diabetes mellitus from their perspectives.
  
  
  METHODS
  A systematic literature review of qualitative studies regarding the contributory factors leading to MRPs, medication errors and non-adherence, followed by a thematic synthesis of the studies.
  
  
  METHODS
  We screened Pubmed, EMBASE, ISI Web of Knowledge, PsycInfo, International Pharmaceutical Abstract and PsycExtra for qualitative studies (interviews, focus groups and questionnaires of a qualitative nature).
  
  
  METHODS
  Thematic synthesis was achieved by coding and developing themes from the findings of qualitative studies.
  
  
  RESULTS
  The synthesis yielded 21 studies that satisfied the inclusion and exclusion criteria. Three themes emerged that involved contributing factors to MRPs: patient-related factors including socioeconomic factors (beliefs, feeling victimised, history of the condition, lack of finance, lack of motivation and low self-esteem) and lifestyle factors (diet, lack of exercise/time to see the doctor, obesity, smoking and stress), medicine-related factors (belief in natural remedies, fear of medicine, lack of belief in medicines, lack of knowledge, non-adherence and polypharmacy) and condition-related factors (lack of knowledge/understanding, fear of condition and its complications, and lack of control).
  
  
  CONCLUSIONS
  MRPs represent a major health threat, especially among adult patients with cardiovascular diseases and/or diabetes mellitus. The patients' perspectives uncovered hidden factors that could cause and/or contribute to MRPs in these groups of patients.
authors.affiliation: Department of Pharmacy, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, Hertfordshire, UK.
authors.forename: A
authors.initials: A
authors.lastname: Al Hamid
authors.affiliation: Department of Pharmacy, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, Hertfordshire, UK.
authors.forename: M
authors.initials: M
authors.lastname: Ghaleb
authors.affiliation: Medication Safety Research Chair, Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.
authors.forename: H
authors.initials: H
authors.lastname: Aljadhey
authors.affiliation: Department of Pharmacy, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, Hertfordshire, UK.
authors.forename: Z
authors.identifier: http://orcid.org/0000-0002-2567-0540
authors.initials: Z
authors.lastname: Aslanpour
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000188:drug therapy*; D003920:Diabetes Mellitus / Q000188:drug therapy*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000209:etiology*; D006801:Humans; D036301:Qualitative Research
keywords: CARDIOLOGY; DIABETES & ENDOCRINOLOGY; QUALITATIVE RESEARCH