Volume 7, Issue 1 (2019)                   HEHP 2019, 7(1): 27-33 | Back to browse issues page

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Zareban I, Fallahi A, Nemat-Shahrbabaki B, Pirakalathanan P. Determinants of treatment adherence among women with osteoporosis: A qualitative study in Iran. HEHP. 2019; 7 (1) :27-33
URL: http://journals.modares.ac.ir/article-5-13560-en.html
1- Health Promotion Research Centre, Zahedan University of Medical Sciences, Zahedan, Iran
2- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran , arezofalahi91@gmail.com
3- Network of Sanandaj, Kurdistan University of Medical Sciences, Sanandaj, Iran
4- Chief Medical Officer, Sonoa Health, Melbourne, Australia
Abstract:   (273 Views)
Aims: Despite the importance of adherence in increasing efficacy of treatment, controlling osteoporosis, and reducing costs of treatment, compliance with osteoporosis medications is less than expected. The aim of this study was to determine treatment adherence among women with osteoporosis.
Participants and Methods: This qualitative research was conducted in Sanandaj, Iran in 2016.
Participants were chosen through purposeful sampling method. Fifteen women with age 50 years and over, diagnosed with osteoporosis for at least 6 months, T-score below -2.5, and previously prescribed osteoporosis medication were selected. To understand the women’s views, semi-structured interviews were recorded, typed, and analyzed using content analysis. Criteria of credibility, confirmability, dependability and transformability were used in order to verify the accuracy and consistency of the data.
Findings: From data analysis, two main themes (Factors related to adherence and factors related to non-adherence) and 10 sub-themes (Social supports, motivational factors, symptomatology, medication side effects, psychological characteristics, economic status, cultural beliefs about illness and treatment, patient’s dissatisfaction, lack of knowledge, and medication factors) were identified.
Conclusion: Treatment adherence is multi-factorial including individual, psychological, social, economic, and cultural factors. Improving health literacy and increasing awareness about the benefits of medications may promote greater medication adherence and improve clinical outcomes for patients with osteoporosis.
Full-Text [PDF 468 kb]   (97 Downloads)    

Received: 2017/04/24 | Accepted: 2018/08/25 | Published: 2019/01/21

References
1. Nielsen D, Huniche L, Brixen K, Sahota O, Masud T. Handling knowledge on osteoporosis -- a qualitative study. Scand J Caring Sci. 2013;27(3):516-24. [Link] [DOI:10.1111/j.1471-6712.2012.01055.x]
2. Fallahi A, Derakhshan S, Pashaee T, Teymoori P. Factors affecting self-care in women with osteoporosis: A qualitative study with the content analysis approach. Sci J Sch Public Health Inst Public Health Res. 2015;13(2):17-32. [Persian] [Link]
3. Sözen T, Özışık L, Başaran N. An overview and management of osteoporosis. Eur J Rheumatol. 2017;4(1):46-56. [Link] [DOI:10.5152/eurjrheum.2016.048]
4. Soleymanian A, Niknami S, Hajizadeh E, Shojaeizadeh D, Montazeri A. Development and validation of a health belief model based instrument for measuring factors influencing exercise behaviors to prevent osteoporosis in pre-menopausal women (HOPE). BMC Musculoskelet Disord. 2014;15:61. [Link] [DOI:10.1186/1471-2474-15-61]
5. Besser SJ, Anderson JE, Weinman J. How do osteoporosis patients perceive their illness and treatment? implications for clinical practice. Arch Osteoporos. 2012;7:115-24. [Link] [DOI:10.1007/s11657-012-0089-9]
6. Rossini M, Bianchi G, Di Munno O, Giannini S, Minisola S, Sinigaglia L, et al. Determinants of adherence to osteoporosis treatment in clinical practice. Osteoporos Int. 2006;17(6):914-21. [Link] [DOI:10.1007/s00198-006-0073-6]
7. Di Matteo MR. Variations in patients' adherence to medical recommendations: A quantitative review of 50 years of research. Med Care. 2004;42(3):200-9. [Link]
8. Chappuy H, Tréluyer JM, Faesch S, Giraud C, Chéron G. Length of the treatment and number of doses per day as major determinants of child adherence to acute treatment. Acta Paediatr. 2010;99(3):433-7. [Link] [DOI:10.1111/j.1651-2227.2009.01601.x]
9. Huybrechts KF, Ishak KJ, Caro JJ. Assessment of compliance with osteoporosis treatment and its consequences in a managed care population. Bone. 2006;38(6):922-8. [Link] [DOI:10.1016/j.bone.2005.10.022]
10. Siris ES, Harris ST, Rosen CJ, Barr CE, Arvesen JN, Abbott TA, et al. Adherence to bisphosphonate therapy and fracture rates in osteoporotic women: Relationship to vertebral and nonvertebral fractures from 2 US claims databases. Mayo Clin Proc. 2006;81(8):1013-22. [Link] [DOI:10.4065/81.8.1013]
11. Lehane E, Mc Carthy G. An examination of the intentional and unintentional aspects of medication non-adherence in patients diagnosed with hypertension. J Clin Nurs. 2007;16(4):698-706. [Link] [DOI:10.1111/j.1365-2702.2005.01538.x]
12. Weycker D, Macarios D, Edelsberg J, Oster G. Compliance with drug therapy for postmenopausal osteoporosis. Osteoporos Int. 2006;17(11):1645-52. [Link] [DOI:10.1007/s00198-006-0179-x]
13. Hekmatpou D, Mohammadi E, Ahmadi F, Arefi SH. Non-compliance factors of congestive heart failure patients readmitted in cardiac care units. Iran J Crit Care Nurs. 2009;2(3):91-7. [Persian] [Link]
14. Mc Combs JS, Thiebaud P, Mc Laughlin-Miley C, Shi J. Compliance with drug therapies for the treatment and prevention of osteoporosis. Maturitas. 2004;48(3):271-87. [Link] [DOI:10.1016/j.maturitas.2004.02.005]
15. Mashrouteh M, Khanjani N, Gozashti MH. Evaluation of compliance with drug regimens in diabetic patients referred to the Endocrinology Clinic of Afzalipour Hospital, Kerman, Iran. J Health Dev. 2012;1(3):182-92. [Persian] [Link]
16. Unson CG, Siccion E, Gaztambide J, Gaztambide S, Mahoney Trella P, Prestwood K. Nonadherence and osteoporosis treatment preferences of older women: A qualitative study. J Womens Health (Larchmt). 2003;12(10):1037-45. [Link] [DOI:10.1089/154099903322643965]
17. Graneheim UH, Lundman B. Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004;24(2):105-12. [Link] [DOI:10.1016/j.nedt.2003.10.001]
18. Morgan DL, Krueger RA. When to use focus groups and why. In: Morgan DL. Successful focus groups: Advancing the state of the art. Morgan DL, editor. Newbury Park: Sage; 1993. pp. 3-20. https://doi.org/10.4135/9781483349008 [Link] [DOI:10.4135/9781483349008.n1]
19. Kvale S. Interviews: An introduction to qualitative research interviewing. Thousand Oaks: Sage Publications; 1996. [Link]
20. Guba EG, Lincoln YS. Effective evaluation: Improving the usefulness of evaluation results through responsive and naturalistic approaches. San Francisco: Jossey-Bass Publishers; 1981. [Link]
21. Sabate E, Organisation mondiale de la santé, World Health Organization, Who, UNAIDS. Adherence to long-term therapies: Evidence for action. Sabate E, Sabaté E, editors. Geneva: World Health Organization; 2003. [Link]
22. Zolnierek KB, Dimatteo MR. Physician communication and patient adherence to treatment: A meta-analysis. Med Care. 2009;47(8):826-34. [Link] [DOI:10.1097/MLR.0b013e31819a5acc]
23. Cooper LA, Roter DL, Bone LR, Larson SM, Miller ER, Barr MS, et al. A randomized controlled trial of interventions to enhance patient-physician partnership, patient adherence and high blood pressure control among ethnic minorities and poor persons: Study protocol NCT00123045. Implement Sci. 2009;4:7. [Link] [DOI:10.1186/1748-5908-4-7]
24. Saadoon OZ, Amin RM, Jadoo SAA. Factors influencing pap smear practice among primary school teachers in Diyala city, Iraq. Malays J Public Health Med. 2014;14(1):19-28. [Link]
25. Lau E, Papaioannou A, Dolovich L, Adachi J, Sawka AM, Burns S, et al. Patients' adherence to osteoporosis therapy: Exploring the perceptions of postmenopausal women. Can Fam Physician. 2008;54(3):394-402. [Link]
26. Clowes JA, Peel NF, Eastell R. The impact of monitoring on adherence and persistence with antiresorptive treatment for postmenopausal osteoporosis: A randomized controlled trial. J Clin Endocrinol Metab. 2004;89(3):1117-23. [Link] [DOI:10.1210/jc.2003-030501]
27. Baheiraei A, Ritchie JE, Eisman JA, Nguyen TV. Exploring factors influencing osteoporosis prevention and control: A qualitative study of Iranian men and women in Australia. Maturitas. 2006;54(2):127-34. [Link] [DOI:10.1016/j.maturitas.2005.09.010]
28. Johnson MJ. The medication adherence model: A guide for assessing medication taking. Res Theory Nurs Pract. 2002;16(3):179-92. [Link] [DOI:10.1891/rtnp.16.3.179.53008]
29. Woods NF, Falk S, Saver B, Taylor TR, Stevens N, Mac Laren A. Deciding about hormone therapy: Validation of a model. Menopause. 1998;5(1):52-9. [Link] [DOI:10.1097/00042192-199805010-00009]
30. Van Der Wal MH, Jaarsma T, Moser DK, Van Gilst WH, Van Veldhuisen DJ. Unraveling the mechanisms for heart failure patients' beliefs about compliance. Heart Lung. 2007;36(4):253-61. [Link] [DOI:10.1016/j.hrtlng.2006.10.007]

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