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Factors Affecting Adherence to Osteoporosis Medications: A Focus Group Approach Examining Viewpoints of Patients and Providers

Iversen, Maura D. PT, DPT, SD, MPH1,2,5; Vora, Ruchita R. PT, MS3; Servi, Amber BA4; Solomon, Daniel H. MD, MS2,4,5

Journal of Geriatric Physical Therapy: April/June 2011 - Volume 34 - Issue 2 - p 72–81
doi: 10.1097/JPT.0b013e3181ff03b4
Research Reports

Purpose: This qualitative study uses a focus group approach to determine factors influencing adherence to osteoporosis medications among older adults. Thirty-two patients aged 65 to 85 years from the Greater Boston area who were prescribed an osteoporosis medication, 11 general medicine physicians, and 1 nurse practitioner were recruited from Boston-based hospitals affiliated with a large health care system.

Method: Focus groups consisting of 6 to 8 subjects including men and women were held separately for providers and patients and conducted until thematic saturation was reached. Responses were obtained from patients and providers during the focus group interviews conducted by a trained focus group moderator. All interviews were audio taped and transcribed by a medical transcriptionist.

Results: According to patients, factors affecting adherence to osteoporosis drugs included lack of knowledge about osteoporosis, dissatisfaction with their doctor visits, side effects, and difficulty or failure to remember instructions for taking medications. Physicians reported lack of patient knowledge, structural barriers, medication side effects, and the inability to track patients' adherence to their medications as barriers to adherence.

Conclusion: This study identifies the extent of and reasons for nonadherence as perceived by patients and providers and provides insights into strategies to modify treatment plans to address nonadherence. The results from this study were used to develop a randomized controlled trial to conduct and evaluate patient- and physician-targeted interventions to improve adherence to osteoporosis medications and to examine cost-effectiveness of alternative strategies.

1Department of Physical Therapy, Northeastern University, Boston, Massachusetts.

2Section of Clinical Sciences, Division of Rheumatology, Immunology & Allergy, Boston, Massachusetts.

3MGH Institute of Health Professions, Boston, Massachusetts.

4Division of Pharmacoepidemiology, Brigham & Women's Hospital, Boston, Massachusetts.

5Harvard Medical School, Boston, Massachusetts.

Address correspondence to: Maura D. Iversen, PT, DPT, SD, MPH, Department of Physical Therapy, Northeastern University, 360 Huntington Ave, 301 Robinson Hall, Boston, MA 02115 (

Copyright © 2011 the Section on Geriatrics of the American Physical Therapy Association
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