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Patients’ adherence to osteoporosis therapy

Exploring the perceptions of postmenopausal women

Alexandra Papaioannou, MD MSc
Associate Professor in the Department of Medicine at McMaster University in Hamilton and a TIPPS investigator

Lisa Dolovich, PharmD MSc
Principal investigator of TIPPS and an Associate Professor in the Department of Family Medicine at McMaster University

Jonathan Adachi, MD
Rheumatologist in the Department of Medicine at St Joseph’s Healthcare in Hamilton

Anna M. Sawka, MD PhD FRCPC
Endocrinologist in the Department of Medicine at St Joseph’s Healthcare

Sheri Burns
Network Coordinator for TIPPS

Kalpana Nair, MEd MSc
Program Coordinator for TIPPS

Anjali Pathak
Research assistant for TIPPS

Correspondence to: Dr Elaine Lau, Department of Pharmacy, Hospital for Sick Children, 555 University Ave, Toronto, ON M5G 1X8; telephone 416 813-6003; fax 416 813-7886; e-mail elaine.lau{at}sickkids.ca

OBJECTIVE To explore the experiences and perceptions of postmenopausal women regarding strategies to improve adherence to osteoporosis therapy.

DESIGN Qualitative, mixed phenomenologic study using focus groups.

SETTING Family physicians’ and specialists’ practices and community pharmacies in Hamilton, Ont.

PARTICIPANTS A total of 37 postmenopausal women currently taking at least 1 prescription or over-the-counter medication for osteoporosis.

METHOD Focus groups were conducted using a semistructured interview guide consisting of 10 open-ended questions about patients’ perceptions of their osteoporosis medications, their reasons for adherence and non-adherence to therapy, and the effectiveness of strategies they had tried to improve adherence. At least 2 research team members analyzed the data to find primary themes.

MAIN FINDINGS Analysis of data from the 7 focus groups found 6 main factors that influenced adherence to medications: belief in the importance of taking medications for osteoporosis, medication-specific factors, beliefs regarding medications and health, relationships with health care providers, information exchange, and strategies to improve adherence. Strategies that facilitated adherence to medications included having a system for taking medications, using cues or reminders, being well informed about the reasons for taking medications, and having regular follow-up by health care providers for support and monitoring after having been prescribed medications.

CONCLUSION Results of this study provide a better understanding of how patients’ perceptions and experiences affect their adherence to osteoporosis medications. Because each patient’s reasons for non-adherence might be different, depending on individual beliefs or circumstances, strategies to improve adherence to medications should be individualized accordingly.

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