Abstract: Objective: To systematically integrate the related factors of medication adherence in patients with osteoporosis, and to provide a basis for developing clinical interventions. Methods: Qualitative studies on medication adherence in patients with osteoporosis were retrieved from Chinese and English databases from inception to June 2, 2025. The quality of the included literature was evaluated and integrated. Results: A total of 11 studies were included. Forty-six findings were extracted and summarized into 13 categories. These were synthesized into promoting factors (perception of disease threat, active coping strategies, doctor-patient trust, family support, and preferences of patients) and hindering factors (insufficient disease awareness, medication beliefs, poor doctor-patient communication, fear of drug side effects, efficacy cognitive bias, competing priorities, daily life interference, and inadequate follow-up and environmental barriers). Conclusion: Multiple factors influence the medication adherence in patients with osteoporosis. It is recommended that medical staff should pay attention to patients' inner experiences and needs when formulating treatment plans, and enhance support systems, so as to improve patients' medication adherence.

Key words: osteoporosis; medication; adherence; qualitative research; Meta-synthesis