University of Massachusetts Medical School Faculty Publications


Adherence to evidence-based secondary prevention pharmacotherapy in patients after an acute coronary syndrome: A systematic review

UMMS Affiliation

Department of Quantitative Health Sciences; Meyers Primary Care Institute

Publication Date


Document Type



Acute Coronary Syndrome; Adult; Aged; Cardiovascular Agents; Databases, Factual; Female; Humans; Male; *Medication Adherence; Middle Aged; Patient Discharge; Risk Factors; Secondary Prevention


Cardiovascular Diseases | Health Services Administration


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.


Acute coronary syndrome, Medication adherence, Pharmacotherapy, Secondary prevention, Systematic review, UMCCTS funding

DOI of Published Version



Heart Lung. 2015 Jul-Aug;44(4):299-308. doi: 10.1016/j.hrtlng.2015.02.004. Epub 2015 Mar 10. Link to article on publisher's site

Related Resources

Link to Article in PubMed

Journal/Book/Conference Title

Heart and lung : the journal of critical care

PubMed ID