Table 4

Perceptions About Medication Taking: Second-Order Constructs

Second-Order ConstructExplanatory NotesArticles
Promote persistence
Unconditional acceptance of treatmentA high regard for clinician advice making prescriptions nonnegotiable2, 6, 10, 13, 15
Perceived security from medication takingTaking medications gives a sense of control and is likely to reduce risk of death and recurrent events4, 8, 9, 14, 15
Symptomatic improvements in physical health promote persistencePositive reinforcements about benefits of medications from noticeable improvements in symptoms4, 9, 12, 14
Routines and physical aidsIncorporating medication taking into daily routine and using blister packs facilitates persistence9, 12, 13, 15
Motivation for persistence driven by belief that medication will prevent further cardiac eventsBelief that medication taking will reduce the risk of death and cardiac events7, 8, 15
Family members as supportersProviding help to sort medications and acting as reminders5, 9, 12
Medications more powerful than lifestyleBelief that medications are more powerful in their action than life-style changes14
Perceived physical dependence on medicationsBelief that their body is physically dependent on medications because they have been used for so long9
Ambivalence toward persistence
Influenced by experiences of friends and familyUsing the experiences of others to shape their own decisions about medication taking2, 6, 9
Health literacyMedication information may or may not be relevant to individual health literacy9, 15
Deter persistence
Confusion about specific medication indicationsConfusion about medications leading to misunderstandings about their relative importance10, 11a, 11b, 11c, 12, 15
Concerns about medications effects on bodiesConcerns about ability to function while taking the medications, including ability to work1, 8, 10, 11a, 11b, 12, 15
Negative information in patient literature causing concernKnowledge of potential adverse effects (eg, from medication inserts, leaflets) leading to expectations that they would occur6, 8, 15
Fear of long-term damage from medication takingFear of damage to organs other than the heart, including cancer7, 9, 10
Cost as a barrierInability to afford medication or access clinic11a, 11b, 11c
Dislike taking tabletsDislike for tablet taking in itself, particularly long term8, 10