title: Adherence to evidence-based secondary prevention pharmacotherapy in patients after an acute coronary syndrome: A systematic review.
abstract: OBJECTIVE
  To synthesize current evidence on medication adherence rates and associated risk factors in patients after an acute coronary syndrome (ACS).
  
  
  METHODS
  A systematic review was conducted. Five electronic databases and article bibliographies were searched for publications from 1990 to 2013 which assessed adherence to secondary prevention pharmacotherapy in adults after hospital discharge for an ACS. Identified studies were screened using pre-defined criteria for eligibility. A standardized form was used for data abstraction. Methodological quality was assessed using modified criteria for quantitative studies.
  
  
  RESULTS
  Sixteen studies met our inclusion criteria. Post-discharge medication adherence rates at 1-year ranged between 54% and 86%. There were no consistent predictors of non-adherence across all cardiac medication classes examined.
  
  
  CONCLUSIONS
  Adherence to secondary prevention pharmacotherapy was suboptimal in patients after hospital discharge for an ACS. Risk factors associated with non-adherence were examined in a limited number of studies, and the associations varied between these investigations.
authors.affiliation: Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA 01605, USA. Electronic address: Han-Yang.Chen@umassmed.edu.
authors.forename: Han-Yang
authors.initials: HY
authors.lastname: Chen
authors.affiliation: Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA 01605, USA; Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA; Meyers Primary Care Institute, University of Massachusetts Medical School, Worcester, MA, USA.
authors.forename: Jane S
authors.initials: JS
authors.lastname: Saczynski
authors.affiliation: Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA 01605, USA.
authors.forename: Kate L
authors.initials: KL
authors.lastname: Lapane
authors.affiliation: Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA 01605, USA.
authors.forename: Catarina I
authors.initials: CI
authors.lastname: Kiefe
authors.affiliation: Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA 01605, USA; Meyers Primary Care Institute, University of Massachusetts Medical School, Worcester, MA, USA.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Goldberg
mesh_terms: D054058:Acute Coronary Syndrome / Q000188:drug therapy* / Q000517:prevention & control; D000328:Adult; D000368:Aged; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D010351:Patient Discharge; D012307:Risk Factors; D055502:Secondary Prevention
chemical_list: D002317:Cardiovascular Agents
keywords: Acute coronary syndrome; Medication adherence; Pharmacotherapy; Secondary prevention; Systematic review