Analysis of Research on Adherence for Secondary Prevention in Patients with Coronary Artery Disease in Korea

Son, Youn Jung; Kim, Sun Hee; Song, Hyo Suk

Abstract

PURPOSE
The purpose of this study was to analyze the research on adherence for secondary prevention in patients with coronary artery disease (CAD) in Korea, and to identify the strategies for improvement that should be included in future studies.
METHODS
Electric literature searches were conducted for Pubmed, CINAHL, RISS4U, KISTI, DBpia, KoreaMed, National Assembly Library, and National Library of Korea. A total of forty two articles published between 1986 and 2009 were selected based on established inclusion criteria.
RESULTS
Forty research papers were related to nursing, and there was only one research paper focused on elderly people with CAD. There were no papers using concept analysis, qualitative study, or randomized controlled clinical trial. Almost all definitions of adherence were adopted from outdated compliance definitions with the attribute of 'paternalistic obligation'. Measurement tools were not based on theoretical framework of adherence but borrowed from tools for measuring self-care, health behavior, or self-efficacy. Overall patient's adherence was analyzed in most studies, except for a few studies which focused on diet and exercise only. Educational strategy was the main strategy used in intervention studies.
CONCLUSIONS
The concept of adherence and measurement tools need to be clarified, along with development of the specific adherence interventions according to the type of adherence in patients with CAD.