University of New South Wales Parramatta, New South Wales, Australia
Sagarika Dey1, Gloria Spratt2, Muguet Koobasi3, Carol Vleeskens4, Carlos El-Haddad5 and Ayano Kelly6, 1School of Clinical Medicine, South Western Sydney Campus, University of New South Wales, Parramatta, New South Wales, Australia, 2Physiotherapy Department and Rheumatology Department, Liverpool Hospital; Zone34 Sports Physiotherapy, Liverpool, Australia, 3Knowledge Centre for Health Ghent, Ghent University, Ghent, Belgium, 4Sydney Partnership for Health Medical Research and Enterprise Consumer Community Council, Liverpool, Australia, 5Rheumatology Department, Liverpool Hospital, Liverpool, Australia, 6South Western Sydney Campus, UNSW Medicine & Health, Braddon, Australia
Background/Purpose: Suboptimal adherence to anti-osteoporotic medications presents a growing social and economic concern. Yet, it is unclear what patients' perspectives and experiences are regarding medication use, and how these vary across phases of adherence, patients' identities and various anti-osteoporotic medications. We aimed to describe patients' perspectives and experiences of medication use in osteoporosis, to inform person-centred interventions that improve adherence and patient outcomes.
Methods: Databases (MEDLINE, Embase, PsycINFO and CINAHL) were searched for qualitative studies reporting on the perspectives and experiences of adults (≥18 years) with osteoporosis and/or osteopenia, and regarding anti-osteoporotic medications, in any language until February, 2022. Inductive thematic analysis was performed. Multiple investigators, including a consumer with lived experience of osteoporosis, have been integral to data analysis.
Results: From 35 articles with 853 adults with osteoporosis or osteopenia, four themes (with sub-themes) were identified:
denial of susceptibility (an invisible disease, unfitting the stereotype, zero tolerance for risks);
disempowered in healthcare relationships (disconnected care, confusion from conflicting advice, resigned to strained communication);
fear of jeopardising normalcy (confronting deterioration and dependency, unnatural and unpredictably toxic, overwhelmed by commitment, deterred by negative experiences);
desiring affirmative support (confidence in empathy, mirroring doctors' persistence, bonding through shared experiences, security in evidence, seeking knowledge and guidance to regain control)
Conclusion: Patients' perceptions of vulnerability, confidence in healthcare relationships, attitudes towards change and accessible support systems can influence their commitment to medication-taking. Offering tailored education may empower patients to make informed decisions regarding treatment risks and benefits, and participate confidently in shared-decision making. Greater time and consistent communication devoted to patients' concerns and expectations can foster a supportive environment that may alleviate the fear and uncertainty associated with adjusting to medications. Continued emphasis on treatment benefits and avenues to voice emerging concerns may promote long-term adherence and health outcomes. Further studies evaluating adherence-improving strategies through the consumers' lens are vital to drive the development of more informed, person-centred interventions and optimise physical, psychosocial and functional outcomes.
Disclosures: S. Dey, None; G. Spratt, None; M. Koobasi, None; C. Vleeskens, None; C. El-Haddad, None; A. Kelly, None.
