# Barriers affecting medication adherence to dienogest among patients with ovarian endometriosis: a qualitative study

## TL;DR

This study identifies barriers to taking dienogest for ovarian endometriosis using a behavioral model and suggests ways to improve medication adherence.

## Contribution

The study applies the COM-B model to explore medication adherence barriers in ovarian endometriosis patients using qualitative interviews.

## Key findings

- Three main barriers were identified: lack of capability, lack of opportunity, and insufficient motivation.
- The COM-B model was effectively used to analyze adherence challenges in this patient group.
- Findings can guide the development of targeted strategies to improve medication adherence.

## Abstract

To explore barriers affecting medication adherence (e.g., missed doses, forgotten doses, or discontinuation) among patients with Ovarian Endometriosis (OE) using the Capability, Opportunity, Motivation – Behaviour (COM-B) behavioural change model as a theoretical framework and propose targeted improvement measures.

A qualitative research approach was used. From March to May 2025, interviews were conducted with 15 patients diagnosed with Ovarian Endometriosis and taking dienogest for over six months at a Grade A tertiary hospital in Linfen City. Data were analysed using directed content analysis.

Three themes were identified: lack of capability, lack of opportunity, and insufficient patient motivation.

This study employed semi-structured interviews combined with the COM-B behavioural change model to systematically analyse barriers affecting dienogest medication adherence among patients with Ovarian Endometriosis. It deeply explored their experiences and perceptions of medication use, providing a reference for developing subsequent intervention strategies to enhance patient medication adherence.