Exploring the factors influencing patient's adherence to anti-osteoporotic medications

Abstract

Osteoporosis is a chronic disease that remains undertreated. This is further compounded by poor adherence to prescribed medications. There is a rising focus on developing and testing interventions to improve adherence, however, interventions have shown mixed results. Current evidence suggests that individualised and multifaceted interventions are needed to optimise adherence. The World Health Organisation identified that healthcare professionals (HCPs) need to be trained to address and deliver adherence interventions. This thesis aimed to add to the ongoing literature about the perspective of stakeholders regarding training needs of HCPs to optimise osteoporosis treatment and adherence. It was the aim to report on the early findings of a pharmacist-led trial to identify areas of patient need and tailor future interventions.

Systematic meta-synthesis and qualitative methods were employed to explore the perspectives and experiences of stakeholders. The perspectives and experiences of HCPs identified the challenges HCPs face in supporting patients to use medicines effectively. The perspectives of adherence experts were explored the content and delivery of medication adherence education for HCPs. Content analysis explored the written information that pharmacists provided to patients as part of the intervention in the trial. Quantitative analyses of survey responses were used to explore patients’ beliefs about osteoporosis medicines enrolled in the trial.

This thesis adds to the current literature in reporting the challenges HCPs face in making treatment-related decisions in the context of clinical and health system barriers. The findings highlight that adherence training needs to incorporate communication strategies and structured approaches to achieve patient-centric goals. The trial findings report on patient factors that could potentially influence adherence and treatment of osteoporosis. Overall, findings highlight key areas for enhancing interventions design.