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.

Systematic review registration: PROSPERO CRD42023424844.

Keywords: Adherence; Caregivers; Medication; Medication management; Myocardial infarction; Patients.

© 2025. The Author(s).

背景：

每年有超过三百万人经历心肌梗死（MI）。随着MI生存率的提高，二次预防药物的重要性也日益增加。国际指南推荐使用多种药物来防止进一步的发病率。

目标：

为了总结有关MI幸存者及其家庭/护理人员在出院后关于药物管理和因此产生的用药依从性方面所面临的促进因素和障碍的定性文献。

方法：

本系统综述按照PRISMA-2020指南进行并报告。从数据库创建到2024年8月13日进行了五次数据库搜索。纳入标准为关注年龄在18岁或以上经历过MI并在急性护理环境中出院回家的人群，以及符合上述条件的个体的家庭照料者。具有定性元素的定性和混合方法研究被认定为符合条件的研究。使用JBI批判性评价工具对定性研究的质量进行评估，并应用来自定性研究审查的信心证据的方法来评估定性证据综合的信心。

结果：

在14,002个标题中，去除重复项后剩下11,354个。在234篇全文筛选文章中，有15篇文章被纳入分析。总计包括来自八个不同国家的533名MI患者和25名配偶。最突出的促进因素是“关于后果的信念”，而“缺乏知识”和“环境背景与资源”是最主要的药物管理障碍。

结论：

患者在心肌梗死后面临多方面的挑战，这些发现强调了制定个体化、量身定制的方法以增强心肌梗死后的用药依从性的重要性。

系统综述注册号：PROSPERO CRD42023424844.

© 2025. 作者保留所有权利。