16 Chapter 2 The classes of cardioprotective medications taken into account were anti-platelet drugs, lipid-lowering drugs, antihypertensive agents (beta-blockers, ACE-inhibitors, ARBs, diuretics, and nitrates), oral hypoglycaemics and insulin. Intervention studies (randomized clinical trials and non-randomized interventions) and observational studies (cross-sectional, cohort and case-control studies) were included. Case reports, case series, reviews, as well as publication types other than original articles were excluded. Study selection The publications resulting from the search were screened by the above eligibility criteria on their titles and abstracts using the platform Rayyan CQRI (16). Screening was conducted by two reviewers (ED, AMF). Each reviewer screened half of the articles, and an additional 10% of the articles was screened by the other reviewer to avoid interpersonal bias. The reviewers discussed discrepancies and unclear include/exclude decisions until consensus was reached. The publications that fulfilled the inclusion and exclusion criteria were screened on their fulltext following the same strategy. Data extraction Relevant data was extracted from the selected publications. Data extraction was performed using the electronic data capture system REDCap (17) by two reviewers (ED, AMF). Each reviewer extracted data from the articles that the other reviewer had previously screened to minimize potential bias. Collected data included information on authors, publication year, publication title, name of the study, language, period in which the study was conducted, country, study design; participants characteristics including specific diagnosis like CHD, acute coronary syndrome (ACS), coronary artery bypass graft (CABG) or percutaneous coronary intervention (PCI); percentage of women, age range, mean age, socioeconomic status (including percentage of participants in the highest income and education categories as well as percentage of employment), and cardiovascular risk factors (blood pressure, body mass index, lipids and glucose levels), care setting information (type of hospital or healthcare centre, e.g. primary care, academic hospital, tertiary hospital, rehabilitation, and whether the centre was public or private), and urbanicity. Outcome data included the prevalence of medication per medication class. In the case of drug intervention studies, we extracted data on medication prevalence at baseline. In publications with an observational design that reported medication prevalence at multiple time-points, we extracted data from the earliest time-point in order to facilitate comparison with intervention studies. If not reported directly, medication prevalence was calculated when possible. Secondary outcome data included guideline compliance (report of compliance or noncompliance), time trends (starting year of the study) and determinants associated with use of medication in patients with established CHD (outcomes reported in stratified analysis or coefficients reported in regression models). Quality assessment
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