The role of psychological factors in adherence to osteoporosis medication: a systematic review

Sarah Jane Besser, Paul Williams, Angel Chater, Janet Anderson, John Weinman

Research output: Working paper


Purpose: Adherence with prescribed osteoporosis medication is often suboptimal to the threshold required for fracture risk reduction. Before designing effective behaviour change interventions to enhance medication adherence, it is essential to identify the determinants of medication-taking behaviour.

Methods: As outlined in the prospectively registered protocol (registration number: CRD42015019184;, five electronic databases were searched (Embase, Medline®, PsychInfo, Scopus and Web of Knowledge) for articles published for the period between January 1980 and March 2017. Studies were included if they used quantitative methods to investigate the psychological determinants/factors related to osteoporosis patients’ adherence with oral medication for the treatment of osteoporosis. Kmet’s quality assessment tool was applied to each paper to assess risk of bias, and 50% of papers were additionally assessed by a second researcher. Data were synthesised through listing (a) the psychological factors investigated (b) the number of studies investigating each factor and (c) the number of studies that report a significant relationship between each factor and adherence.

Results: We identified 1788 articles, of which 22 met the inclusion criteria and were reviewed. The data synthesis showed that patient knowledge and the experience of side effects play an important role in osteoporosis medication adherence. Factors that warrant further research have been identified and include emotional response, motivation and doctor-patient communication.

Conclusions: There is evidence to suggest that patient perceptions and other psychological factors play a role in osteoporosis medication adherence. These factors should be the target of future evidence-based psychological/behavioural interventions to facilitate adherence to osteoporosis medication.
Original languageEnglish
Publication statusSubmitted - 11 Nov 2016


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