ArticleNursing open2026
Understanding Medication Adherence in Patients With Primary Osteoporosis in China: A Qualitative Study Guided by the Integrated Theory of Health Behavior Change.
Article in Nursing open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
aimTo qualitatively analyse determinants of medication adherence in Chinese patients with PO using the Integrated Theory of Health Behavior Change (ITHBC).
designThe study was conducted as a qualitative study using. The data is systematically analysed using thematic analysis method. We followed the COREQ Checklist to ensure rigour in our study.
methodsThis qualitative descriptive study, guided by the ITHBC, was conducted at a national medical center in China (November 2023-June 2024). Sixteen patients with PO were purposively sampled until data saturation. Semi-structured interviews were analysed using directed thematic analysis.
resultsMedication adherence was conceptualized as a dynamic, self-regulatory process shaped by three interconnected components: (i) Intrinsic drivers: Patients' illness perceptions, treatment beliefs and knowledge formed the cognitive and motivational foundation. (ii) External scaffold: Family support functioned as a multidimensional facilitator through instrumental, emotional, informational and financial aid. (iii) Systemic barriers: Healthcare system inefficiencies and daily routine disruptions depleted self-regulatory resources. Their interplay manifested in three emergent behavioural patterns: passive compliance, active engagement, and experiential learning.
conclusionMedication adherence in Chinese patients with PO arises from interactions among individual cognition, family dynamics and systemic environment. The ITHBC provides a useful framework for understanding these mechanisms. Future interventions should address patient beliefs, mobilize family support and redesign healthcare systems to reduce barriers. PATIENT CONTRIBUTION: Sixteen patients diagnosed with primary osteoporosis participated in this qualitative study by sharing their personal experiences and perspectives through in-depth interviews. Their contributions provided essential insights into the facilitators and barriers to medication adherence, directly informing the study's findings and implications for nursing practice.
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