***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Adherence to evidence based medicines in patients who have experienced a myocardial infa rct ion remains low . Individual ’s beliefs towards their medicines are a strong predictor of adherence and may influence other factors that impact on adherence . Objective To investigate if community pharmacists discussing patients ’ beliefs about their medicines improved medication adherence at 12 months post myocardial infa rct ion . Setting This study included 200 patients discharged from a public teaching hospital in Queensl and , Australia , following a myocardial infa rct ion . Patients were r and omised into intervention ( n = 100 ) and control groups ( n = 100 ) and followed for 12 months . Method All patients were interviewed between 5 to 6 weeks , at 6 and 12 months post discharge by the research er using the repertory grid technique . This technique was used to elicit the patient ’s individualised beliefs about their medicines for their myocardial infa rct ion . In the intervention group , patients ’ beliefs about their medicines were communicated by the research er to their community pharmacist . The pharmacist used this information to tailor their discussion with the patient about their medication beliefs at design ated time points ( 3 and 6 months post discharge ) . The control group was provided with usual care . Main outcome measure The difference in non-adherence measured using a medication possession ratio between the intervention and control groups at 12 months post myocardial infa rct ion . Results There were 137 patients remaining in the study ( intervention group n = 72 , control group n = 65 ) at 12 months . In the intervention group 29 % ( n = 20 ) of patients were non-adherent compared to 25 % ( n = 16 ) of patients in control group . Conclusion Discussing patients ’ beliefs about their medicines for their myocardial infa rct ion did not improve medication adherence . Further research on patients beliefs should focus on targeting non-adherent patients whose reasons for their non-adherence is driven by their medication beliefs BACKGROUND Adherence to drugs and healthy lifestyles is low after acute coronary syndrome . We assessed whether trained community health workers could improve adherence to drugs , lifestyle changes , and clinical risk markers in patients with acute coronary syndrome in India . METHODS In this study done at 14 hospitals in India we r and omly assigned ( 1:1 ) patients with acute coronary syndrome 1 or 2 days before discharge from hospital to a community health worker-based intervention group or a st and ard care group . Patients were r and omly assigned with a telephone r and omisation service . In the intervention group , during four in-hospital and two home visits , community health workers used unstructured discussion s , visual methods , and patient diaries to educate patients on healthy lifestyle and drugs , and measures to enhance adherence . The primary outcome was adherence to proven secondary prevention drugs ( antiplatelet drugs , β blockers , angiotensin-converting enzyme inhibitors or angiotensin receptor blockers , and statins )  estimated using a Composite Medication Adherence Scale at 1 year . The secondary outcomes were difference in lifestyle factors ( diet , exercise , and tobacco and alcohol use ) , and clinical risk markers ( blood pressure , bodyweight , BMI , heart rate , and lipids ) . All analyses were by intention to treat . This trial is registered with the Clinical Trial Registry of India , number REF/2013/03/004737 , and Clinical Trials.gov , number NCT01207700 . RESULTS Between Aug 23 , 2011 , and June 25 , 2012 , 806 participants were r and omly assigned ( 405 to a community health worker-based intervention group and 401 to a st and ard care group ) . At 1 year , 40 patients had died and 15 had discontinued or been lost to follow-up , so 750 ( 93 % ) were included in the analyses ( 375 in each group ) . Secondary prevention drugs prescribed at discharge were 98 % ( 786/803 ) for any antiplatelet drug , 79 % ( 638/803 ) for dual antiplatelet drugs , 69 % ( 555/803 ) for β blockers , 69 % ( 552/803 ) for angiotensin-converting enzyme inhibitors and angiotensin receptor blockers , and 95 % ( 762/803 ) for statins  . At one year , overall adherence ( ≥80 % ) to prescribed evidence -based drugs was higher in the intervention group than in the control group ( 97 % vs 92 % , odds ratio [ OR ] 2·62 , 95 % CI 1·32 - 5·19 ; p=0·006 ) . For individual drugs , we recorded significant differences for angiotensin-converting enzyme inhibitors and angiotensin receptor blockers ( 97 % [ 233/240 ] in the intervention group vs 93 % [ 223/240 ] in the control group ; p=0·036 ) and statins ( 97 % [ 346/356 ] vs 93 % [ 321/345 ] ; p=0·011 ) . The intervention group had significantly greater adherence to smoking cessation  ( 85 % [ 110/129 ] vs 52 % [ 71/138 ] , OR 5·46 , 95 % CI 3·03 - 9·86 ; p<0·0001 ) , regular physical activity ( 89 % [ 333/375 ] vs 60 % [ 226/375 ] , OR 5·23 , 95 % CI 3·57 - 7·66 ; p<0·0001 ) , and healthy diet  ( score 5·0 vs 3·0 , OR 2·47 , 95 % CI 1·88 - 3·25 ; p<0·0001 ) . More patients in the intervention group had stopped alcohol use at 1 year ( 87 % [ 64/74 ] vs 46 % [ 46/67 ] , OR 2·92 , 95 % CI 1·26 - 6·79 ; p = 0·010 ) . At 1 year , the mean systolic blood pressure ( 124·4 mm Hg [ SD 13·5 ] vs 128·0 mm Hg [ 15·9 ] ; p=0·002 ) , weight ( 65·0 kg [ 11·0 ] vs 66·5 kg [ 11·5 ] ; p<0·0001 ) , cholesterol ( 157·0 [ 40·2 ] vs 166·9 [ 48·4 ] ; p=0·184 ) , LDL ( 81·0 [ 20·6 ] vs 87·3 [ 29·9 ] ; p=0·191 ) , HDL ( 42·0 [ 11·4 ] vs 38·2 [ 6·5 ] ; p=0·042 ) , and BMI ( 24·4 kg/m(2 ) [ SD 3·7 ] vs 25·0 kg/m(2 ) [ 3·8 ] ; p<0·0001 ) were lower in the intervention group than in the control group . However , we noted no significant difference in diastolic blood pressure and heart rate . INTERPRETATION A community health worker-based personalised intervention strategy in patients with acute coronary syndrome  improved adherence to evidence -based drugs and healthy lifestyles , and result ed in an improvement in clinical risk markers . Integration of trained community health workers can improve secondary prevention in coronary artery disease . FUNDING US National Heart , Lung , and Blood Institute ( NHLBI ) , National Institutes of Health , Department of Health and Human Services , and the UnitedHealth group , USA Background : Adherence to dietary and medication regimen plays an important role in successful treatment and reduces the negative complications and severity of the disease . Therefore , the present study aim ed to investigate the effect of nurse-led telephone follow-up on the level of adherence to dietary and medication regimen among patients after Myocardial Infa rct ion ( MI ) . Methods : This non-blinded r and omized controlled clinical trial was conducted on 100 elderly patients with MI who had referred to the cardiovascular clinics in Shiraz . Participants were selected and r and omly assigned to intervention and control groups using balanced block r and omization method . The intervention group received a nurse-led telephone follow-up . The data were collected using a demographic question naire , Morisky ’s 8-item medication adherence question naire , and dietary adherence question naire before and three months after the intervention . Data analysis was done by the SPSS statistical software ( version 21 ) , using paired t-test for intra-group and Chi-square and t-test for between groups comparisons . Significance level was set at<0.05 . Results : The results of Chi-square test showed no statistically significant difference between the intervention and control groups with respect to their adherence to dietary and medication regimen before the intervention ( P>0.05 ) . However , a statistically significant difference was found between the two groups in this regard after the intervention ( P<0.05 ) . The mean differences of dietary and medication adherence scores between pre- and post-tests were significantly different between the two groups . Independent t-test showed these differences ( P=0.001 ) . Conclusion : The results of the present study confirmed the positive effects of nurse-led telephone follow-up as a method of tele-nursing on improvement of adherence to dietary and medication regimen in the patients with MI . Trial Registration Number : I RCT Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more Objectives We investigated whether an intervention mainly consisting of a signed agreement between patient and physician on the objectives to be reached , improves reaching these secondary prevention objectives in modifiable cardiovascular risk factors six-months after discharge following an acute coronary syndrome . Background There is room to improve mid-term adherence to clinical guidelines ' recommendations in coronary heart disease secondary prevention , specially non-pharmacological ones , often neglected . Methods In CAM-2 , patients discharged after an acute coronary syndrome were r and omly assigned to the intervention or the usual care group . The primary outcome was reaching therapeutic objectives in various secondary prevention variables : smoking , obesity , blood lipids , blood pressure control , exercise and taking of medication . Results 1757 patients were recruited in 64 hospitals and 1510 ( 762 in the intervention and 748 in the control group ) attended the six-months follow-up visit . After adjustment for potentially important variables , there were , between the intervention and control group , differences in the mean reduction of body mass index ( 0.5 vs. 0.2 ; p < 0.001 ) and waist circumference ( 1.6 cm vs. 0.6 cm ; p = 0.05 ) , proportion of patients who exercise regularly and those with total cholesterol below 175 mg/dl ( 64.7 % vs. 56.5 % ; p = 0.001 ) . The reported intake of medications was high in both groups for all the drugs considered with no differences except for statins ( 98.1 % vs. 95.9 % ; p = 0.029 ) . Conclusions At least in the short term , lifestyle changes among coronary heart disease patients are achievable by intensifying the responsibility of the patient himself by means of a simple and feasible intervention AIM AND BACKGROUND Studies have reported that adherence to medications after hospital discharge for myocardial infa rct ion is poor with about 12 % to 20 % of patients discontinue their medications six months after discharge . This study aim ed to examine the effect of self-efficacy enhancement program on medication adherence in post-acute myocardial infa rct ion patients . METHODS A total 44 patient with post-acute myocardial infa rct ion were recruited from the in-patient department , Police General Hospital . The participants were r and om assigned into control group and experimental group . The control group received conventional care while the experimental group attended a four-week self-efficacy enhancement program , which included motivation , skill practice , and monitoring skills . The mean self-efficacy score between groups was assessed . The pill count was used to measure medication adherence . Correlations between self-efficacy and medication adherence were examined . Data were analyzed using descriptive statistic , Pearson 's correlation , and t-test . RESULTS The mean score on medication adherence of the experiment group who attended the self-efficacy enhancement program was significantly greater than the control group ( t=-2.77 ; df=21 ; p=0.01 ) . The mean scores of self-efficacy between the experimental and control group were 35.73 ( SD=4.11 ) and 35.41 ( SD=3.78 ) . The correlations between self-efficacy and medication adherence were significantly ( r=1.00 , p=0.00 ) . CONCLUSION The effectiveness of self-efficacy enhancement program was effective in improving medication adherence in Thai post-acute myocardial infa rct ion Background : Short hospital stays for patients with acute coronary syndromes ( A 
    Output:
    
HCP-led interventions for ACS patients appear to have a small positive impact on medication adherence .
While we were able to identify BCTs among interventions , data were insufficient to determine the impact of particular BCTs on study effectiveness .