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

Objective: 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. Methods: 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. Results: Three themes were identified: lack of capability, lack of opportunity, and insufficient patient motivation. Conclusion: 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.