title: Factors affecting adherence to osteoporosis medications: a focus group approach examining viewpoints of patients and providers.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Physical Therapy, Northeastern University, Boston, Massachusetts 02115, USA. m.iversen@neu.edu
authors.forename: Maura D
authors.initials: MD
authors.lastname: Iversen
authors.forename: Ruchita R
authors.initials: RR
authors.lastname: Vora
authors.forename: Amber
authors.initials: A
authors.lastname: Servi
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Solomon
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D050071:Bone Density Conservation Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D005260:Female; D017144:Focus Groups; D058005:General Practitioners; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D009722:Nurse Practitioners; D010024:Osteoporosis / Q000188:drug therapy*; D017060:Patient Satisfaction; D011369:Professional-Patient Relations; D036301:Qualitative Research; D017010:Reminder Systems; D020377:Self Efficacy; D035502:Trust
chemical_list: D050071:Bone Density Conservation Agents