Association of functional and structural social support with medication adherence among individuals treated for coronary heart disease risk factors: Findings from the REasons for Geographic and Racial Differences in Stroke (REGARDS) study.

Background: Functional social support has a stronger association with medical treatment adherence than structural social support in several populations and disease conditions. Using a contemporary U.S. population of adults treated with medications for coronary heart disease (CHD) risk factors, the association between social support and medication adherence was examined.
Methods: We included 17,113 black and white men and women with CHD or CHD risk factors aged ≥45 years recruited 2003-2007 from the REasons for Geographic and Racial Differences in Stroke (REGARDS) study. Participants reported their perceived social support (structural social support: being partnered, number of close friends, number of close relatives, and number of other adults in household; functional social support: having a caregiver in case of sickness or disability; combination of structural and functional social support: number of close friends or relatives seen at least monthly). Medication adherence was assessed using a 4-item scale. Multi-variable adjusted Poisson regression models were used to calculate prevalence ratios (PR) for the association between social support and medication adherence.
Results: Prevalence of medication adherence was 68.9%. Participants who saw >10 close friends or relatives at least monthly had higher prevalence of medication adherence (PR = 1.06; 95% CI: 1.00, 1.11) than those who saw ≤3 per month. Having a caregiver in case of sickness or disability, being partnered, number of close friends, number of close relatives, and number of other adults in household were not associated with medication adherence after adjusting for covariates.
Conclusions: Seeing multiple friends and relatives was associated with better medication adherence among individuals with CHD risk factors. Increasing social support with combined structural and functional components may help support medication adherence.
Competing Interests: I have read the journal's policy and the authors of this manuscript have the following competing interests: F.L.M receives funding from the American Heart Association Predoctoral Fellowship, A.P.C. receives funding from Amgen for unrelated work, R.W.D receives funding from Amgen and Amarin for unrelated work, M.W.L. has no relationships to disclose, M.M.S receives funding from Amgen and diaDexus for unrelated work, E.B.L receives funding from Amgen for unrelated work and has consulted for Amgen and Novartis. This does not alter our adherence to PLOS ONE policies on sharing data and materials.