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Themes in the Literature Related to Cardiovascular Disease Risk Reduction

Cohen, Shannon Munro MSN, APRN, BC, FNP-C; Kataoka-Yahiro, Merle PhD

The Journal of Cardiovascular Nursing: July-August 2009 - Volume 24 - Issue 4 - p 268-276
doi: 10.1097/JCN.0b013e3181a6de90

Purpose: This article aimed to identify themes in the literature related to patient-healthcare provider beliefs, barriers to adherence, and interventions pertaining to cardiovascular disease risk reduction.

Methods: Twenty quantitative and qualitative primary research studies including 2 meta-analyses published between 1995 and 2008 were analyzed for themes and practice implications to synthesize existing research on cardiovascular disease risk reduction. Databases searched included EBSCO, CINAHL, MEDLINE, ScienceDirect, HealthSource, and PsychLit using the search terms patient- provider adherence, adherence and shared decision making, adherence and decision support, patient- provider goal setting, and cardiovascular disease risk reduction.

Results: The emergent themes found in this literature review included (1) complex medication regimens; (2) risk perception, quality of life, and competing priorities; (3) motivation for change; (4) provider clinical inertia; and (5) goal setting, feedback, and reminders. Studies reporting the highest rates of adherence to cardiovascular disease risk reduction recommendations incorporated patient-provider goal setting and decision support, self-management techniques, and personalized printed communication.

Implications for practice: Goal setting in cardiovascular disease risk reduction is a relatively unexplored area and is an important component of shared decision making and adherence to cardiovascular disease health recommendations. The following review will address the 5 themes identified in more detail and provide a basis for improved clinical practice.

Shannon Munro Cohen, MSN, APRN, BC, FNP-C PhD candidate, Family Nurse Practitioner, University of Hawaii, Manoa.

Merle Kataoka-Yahiro, PhD Dissertation Committee Chair, University of Hawaii, Manoa.

Corresponding author Shannon Munro Cohen, MSN, APRN, BC, FNP-C, University of Hawaii at Manoa, Honolulu, HI 96822 (

© 2009 Lippincott Williams & Wilkins, Inc.