Abstract: Objective: To study the key influencing factors of medication adherence in patients with chronic diseases and to provide reference for related research. Methods: The influencing factors of medication adherence in patients with chronic diseases were systematically sorted out through literature review and integrated with the capacity, opportunity, motivation-behavior (COM-B) model as the analytical framework. Results: Medication adherence in patients with chronic diseases is directly or indirectly influenced by 3 types of factors: capacity factors such as physiological and cognitive functional status, disease and medication knowledge levels and habits, opportunity factors such as information acquisition, learning opportunities, social influence, significant others and financial support, and motivation factors such as self-efficacy, goals, disease perception, and attitudes toward medications. Conclusion: Medication adherence of chronic disease patients is affected by multidimensional factors, the research dimension of influencing factors expands from single to multidimensional, the research methodology changes from observational to interventional research, and the strategy of medication adherence enhancement should be constructed from multiple dimensions for different subjects.

Key words: chronic disease, medication adherence, medication behavior, influencing factors, COM-B

摘要： 目的：研究慢性病患者用药依从性的关键影响因素，为相关研究提供参考。方法：通过文献回顾系统梳理慢性病患者用药依从性的影响因素，以能力、机会、动机-行为（capacity, opportunity, motivation-behavior, COM-B）模型为分析框架进行整合。结果：慢性病患者用药依从性受到生理及认知功能状态、疾病和药物知识水平以及习惯等能力因素，信息获取、学习机会、社会影响、重要人物及经济支持等机会因素和自我效能、目标、疾病感知、对药物的态度等动机因素3类因素直接或间接的影响。结论：慢性病患者的用药依从性受到多维度因素影响，影响因素的研究维度从单一向多维拓展，研究方法从观察性研究向干预性研究转变，应针对不同主体从多个维度构建用药依从性的提升策略。

关键词: 慢性病, 用药依从性, 用药行为, 影响因素, COM-B模型