Barriers and facilitators to managing medicines at home post-myocardial infarction: a qualitative systematic review

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Date
2025-06-04
Authors
El‑Komy, Fatma
Sahm, Laura J.
Byrne, Stephen
Bermingham, Margaret
O’Driscoll, Michelle
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Springer Nature Switzerland AG
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https://doi.org/10.1007/s11096-025-01927-x
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Abstract
Background Over three million people annually experience myocardial infarction (MI). As MI survival rates increase, so does the importance of secondary prevention medications. International guidelines recommend using several medications to prevent further morbidity. Aim To synthesise the qualitative literature on the facilitators and barriers faced by MI survivors and their families/caregivers regarding medication management and, thus, medication adherence post-discharge. Method This systematic review was conducted and reported following the PRISMA-2020 guidelines. Five databases were searched from inception until the 13th of August 2024. The inclusion criteria were articles focused on people aged 18 years or older who experienced MI and were discharged from acute care settings to home settings, as well as caregivers of individuals who met the above-mentioned criteria. Qualitative and mixed-methods studies with qualitative elements were deemed eligible for inclusion. The theoretical domain framework was used to analyse the findings. The quality of the included studies was assessed using the JBI Critical Appraisal tool for qualitative research. The Confidence in the Evidence from the reviews of qualitative research approach was applied to assess confidence in qualitative evidence synthesis. Results Of the 14,002 titles, 11,354 remained after duplicates were removed. Of the 234 full-text screenings, fifteen were included. A total of 533 people who experienced MI and 25 spouses from eight different countries were included. The most prominent facilitator that emerged was “beliefs about consequences”, whilst “lack of knowledge” and “environmental context and resources” were the most prominent barriers to medication management reported. Conclusion Patients face multiple challenges that affect their medication adherence post-MI. These findings highlight important considerations for creating an individualised, tailored approach to enhance medication adherence post-MI.
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Keywords
Adherence , Caregivers , Medication , Medication management , Myocardial infarction , Patients
Citation
El-Komy, F., Sahm, L.J., Byrne, S., Bermingham, M. and O’Driscoll, M. (2025) ‘Barriers and facilitators to managing medicines at home post-myocardial infarction: a qualitative systematic review’, International Journal of Clinical Pharmacy [Preprint]. https://doi.org/10.1007/s11096-025-01927-x
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https://hdl.handle.net/10468/17642
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Pharmacy - Journal Articles
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© 2024, The Authors. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.