Skip to main content
SpringerLink
Log in

Social Support and Adherence to Treatment in Hypertensive Patients: A Meta-Analysis

  • Original Article
  • Published:
Annals of Behavioral Medicine

Abstract

Background

It is important to examine factors associated with patient adherence to hypertension control strategies.

Purpose

A meta-analysis was conducted to examine whether social support was related to adherence to healthy lifestyle and treatment medication in hypertensive patients.

Methods

Journal articles were searched in medical (CINAHL, MEDLINE), psychological (PsycINFO, PsycARTICLES), and educational (ERIC) electronic databases; in reference lists of selected papers; and in the reference list of a previous review.

Results

Findings of a set of meta-analyses indicated that (a) structural social support was not significantly related to overall adherence, (b) functional social support was significantly and positively related to overall adherence, (c) these findings were further confirmed in meta-analyses conducted on specific types of adherence, and (d) most results were characterized by heterogeneity across studies that was partially explained by moderator analyses.

Conclusions

Functional social support, but not structural social support, was associated with adherence in hypertensive patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Notes

  1. We hypothesized that two additional variables could moderate study results: complexity of drug regimen (i.e., operationalized as the mean number of prescribed drugs) and length of hypertensive diagnosis (i.e., defined as years from diagnosis). However, we could not proceed with testing these two moderators since most studies did not report this information.

References

  1. Chobanian AV, Bakris GL, Black HR, et al. Seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertension. 2003; 42(6): 1206-1252.

    Article  CAS  PubMed  Google Scholar 

  2. World Health Organization. Blood pressure: Raised blood pressure (SBP ≥ 140 OR DBP ≥ 90) data by WHO region. Report generated from the Global Health Observatory http://apps.who.int/ghodata. Accessed January 28, 2013.

  3. Kearney PM, Whelton M, Reynolds K, et al. Global burden of hypertension: Analysis of worldwide data. Lancet. 2005; 365: 217-223.

    Article  PubMed  Google Scholar 

  4. Kannel WB. Hypertension: Reflections on risks and prognostication. Med Clin North Am. 2009; 93(3): 541-558.

    Article  PubMed Central  PubMed  Google Scholar 

  5. Mancia G, Fagard R, Narkiewicz K, et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension. J Hypertens. 2013; 31(7): 1281-1357.

    Article  CAS  PubMed  Google Scholar 

  6. Degli Esposti L, Valpiani G. Pharmacoeconomic burden of undertreating hypertension. PharmacoEconomics. 2004; 22(14): 907-928.

    Article  PubMed  Google Scholar 

  7. Costa FV. Compliance with antihypertensive treatment. Clin Exp Hypertens. 1996; 18: 463-472.

    Article  CAS  PubMed  Google Scholar 

  8. Ostchega Y, Yoon SS, Hughes J, et al. Hypertension awareness, treatment, and control—Continued disparities in adults: United States, 2005–2006. Hyattsville: National Center for Health Statistics; 2008.

    Google Scholar 

  9. World Health Organization. Adherence to long-term therapies: Evidence for action. Online document retrieved from www.who.int/chp/knowledge/publications/adherence_report/en/index.html; 2003.

  10. DiMatteo MR, Haskard KB, Williams SL. Health beliefs, disease severity, and patient adherence: A meta-analysis. Med Care. 2007; 45(6): 521-528.

    Article  PubMed  Google Scholar 

  11. York Cornwell EY, Waite LJ. Social network resources and management of hypertension. J Health Soc Behav. 2012; 53(2): 215-231.

    Article  Google Scholar 

  12. Bosworth HB, Olsen MK, Neary A, et al. Take control of your blood pressure (TCYB) study: A multifactorial tailored behavioral and educational intervention for achieving blood pressure control. Patient Educ Couns. 2008; 70(3): 338-347.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Khatib R, Schwalm J, Yusuf S, et al. Patient and healthcare provider barriers to hypertension awareness, treatment and follow up: A systematic review and meta-analysis of qualitative and quantitative studies. PLoS ONE. 2014; 9(1): 1-12.

    Article  Google Scholar 

  14. DiMatteo MR. Social support and patient adherence to medical treatment: A meta-analysis. Health Psychol. 2004; 23(2): 207-218.

    Article  PubMed  Google Scholar 

  15. Holt-Lunstad J, Smith TB, Layton JB. Social relationships and mortality risk: A meta-analytic review. PLoS Med. 2010; 7(7): 1-20.

    Article  Google Scholar 

  16. Cohen S. Social relationships and health. Am Psychol. 2004; 59(8): 676-684.

    Article  PubMed  Google Scholar 

  17. Carels RA, Blumenthal JA, Sherwood A. Effect of satisfaction with social support on blood pressure in normotensive and borderline hypertensive men and women. Int J Behav Med. 1998; 5(1): 76-85.

    Article  CAS  PubMed  Google Scholar 

  18. Hill PL, Weston SJ, Jackson JJ. Connecting social environment variables to the onset of major specific health outcomes. Psychol Health. 2014; 29(7): 753-767.

    Article  PubMed  Google Scholar 

  19. Cohen S, Wills TA. Stress, social support, and the buffering hypothesis. Psychol Bull. 1985; 98(2): 310-357.

    Article  CAS  PubMed  Google Scholar 

  20. Schwarzer R, Rieckmann N. Social support, cardiovascular disease, and mortality. In: Weidner G, Kopp MS, Kristenson M, eds. Heart disease: Environment, stress, and gender. NATO Science Series, Series I: Life and Behavioural Sciences, vol. 327. Amsterdam: IOS Press; 2002: 185-197.

    Google Scholar 

  21. Schwarzer R, Knoll N. Social support. In: French D, Kaptein A, Vedhara K, Weinman J, eds. Health psychology. 2nd ed. Oxford: Wiley-Blackwell; 2010: 283-293.

    Google Scholar 

  22. Barth J, Schneider S, Von Känel R. Lack of social support in the etiology and the prognosis of coronary heart disease: A systematic review and meta-analysis. Psychosom Med. 2010; 72(3): 229-238.

    Article  PubMed  Google Scholar 

  23. Uchino BN, Cacioppo JT, Kiecolt-Glaser JK. The relationship between social support and physiological processes: A review with emphasis on underlying mechanisms and implications for health. Psychol Bull. 1996; 119(3): 488-531.

    Article  CAS  PubMed  Google Scholar 

  24. Cohen J. Statistical power analysis for the behavioral sciences. New York: Academic Press; 1988.

    Google Scholar 

  25. Hedges LV, Vevea JL. Fixed- and random-effects models in meta-analysis. Psychol Methods. 1998; 3: 486-504.

    Article  Google Scholar 

  26. Huedo-Medina TB, Sánchez-Meca J, Marin-Martinez F, et al. Assessing heterogeneity in meta-analysis: Q statistic or I2 index? Psychol Methods. 2006; 11(2): 193-206.

    Article  PubMed  Google Scholar 

  27. Higgins J, Thompson SG, Deeks JJ, et al. Measuring inconsistency in meta-analysis. Brit Med J. 2003; 327: 557-560.

    Article  PubMed Central  PubMed  Google Scholar 

  28. Rothstein HR, Sutton AJ, Borenstein M, eds. Publication bias in meta-analysis. Chichester: Wiley; 2005.

    Google Scholar 

  29. Egger M, Davey Smith G, Schneider M, et al. Bias in meta-analysis detected by a simple, graphical test. Brit Med J. 1997; 315: 629-634.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  30. Duval S, Tweedie R. A nonparametric ‘trim and fill’ method of accounting for publication bias in meta-analysis. J Am Stat Assoc. 2000; 95: 89-98.

    Google Scholar 

  31. Duval S. The trim and fill method. In: Rothstein HR, Sutton AJ, Borenstein M, eds. Publication bias in meta-analysis. Chichester: Wiley; 2005: 11-33.

    Google Scholar 

  32. Kemppainen J, Bomar PJ, Kikuchi K, et al. Health promotion behaviors of residents with hypertension in Iwate, Japan and North Carolina, USA. Jpn J Nurs Sci. 2011; 8(1): 20-32.

    Article  PubMed  Google Scholar 

  33. Al-Mehza AM, Al-Muhailije FA, Khalfan MM, et al. Drug compliance among hypertensive patients: An area based study. Eur J Gen Med. 2009; 6(1): 6-10.

    Google Scholar 

  34. Cavalari E, Nogueira MS, Fava SMCL, et al. Adherence to treatment: A study with hypertensive outpatients [Portuguese]. Rev Enfermagem UERJ. 2012; 20(1): 67-72.

    Google Scholar 

  35. Cummings KM, Kirscht JP, Binder LR, et al. Determinants of drug treatment maintenance among hypertensive persons in inner city Detroit. Public Health Rep. 1982; 97(2): 99-106.

    PubMed Central  CAS  PubMed  Google Scholar 

  36. Gee ME, Campbell NRC, Gwadry-Sridhar F, et al. Antihypertensive medication use, adherence, stops, and starts in Canadians with hypertension. Can J Cardiol. 2012; 28(3): 383-389.

    Article  PubMed  Google Scholar 

  37. Gohar F, Greenfield SM, Beevers DG, et al. Self-care and adherence to medication: A survey in the hypertension outpatient clinic. BMC Complement Altern Med. 2008; 8(1): 1-9.

    Article  Google Scholar 

  38. Hassan NB, Hasanah CI, Foong K, et al. Identification of psychosocial factors of noncompliance in hypertensive patients. J Hum Hypertens. 2006; 20(1): 23-29.

    Article  CAS  PubMed  Google Scholar 

  39. Hershey JC, Morton BG, Davis JB, et al. Patient compliance with antihypertensive medication. Am J Public Health. 1980; 70(10): 1081-1089.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  40. Jones PK, Jones SL, Katz J. Improving follow-up among hypertensive patients using a health belief model intervention. Arch Intern Med. 1987; 147(9): 1557-1560.

    Article  CAS  PubMed  Google Scholar 

  41. Joshi PP, Salkar RG, Heller RF. Determinants of poor blood pressure control in urban hypertensive of central India. J Hum Hypertens. 1996; 10(5): 299-303.

    CAS  PubMed  Google Scholar 

  42. Jung J. Global versus health-specific social support and match of preferred and perceived social support levels in relationship to compliance and blood pressure of hypertensives. J Appl Soc Psychol. 1990; 20(13): 1103-1111.

    Article  Google Scholar 

  43. Krousel-Wood MA, Muntner P, Islam T, et al. Barriers to and determinants of medication adherence in hypertension management: Perspective of the cohort study of medication adherence among older adults. Med Clin North Am. 2009; 93(3): 753-769.

    Article  PubMed Central  PubMed  Google Scholar 

  44. Krousel-Wood M, Islam T, Muntner P, et al. Association of depression with antihypertensive medication adherence in older adults: Cross-sectional and longitudinal findings from CoSMO. Ann Behav Med. 2010; 40(3): 248-257.

    Article  PubMed Central  PubMed  Google Scholar 

  45. Kyngäs H, Lahdenperä T. Compliance of patients with hypertension and associated factors. J Adv Nurs. 1999; 29(4): 832-839.

    Article  PubMed  Google Scholar 

  46. Lancaster KJ. Characteristics influencing daily consumption of fruits and vegetables and low-fat dairy products in older adults with hypertension. J Nutr Elder. 2004; 23(4): 21-33.

    Article  PubMed  Google Scholar 

  47. Li WW, Wallhagen MI, Froelicher ES. Hypertension control, predictors for medication adherence and gender differences in older Chinese immigrants. J Adv Nurs. 2008; 61(3): 326-335.

    Article  PubMed  Google Scholar 

  48. Lim TO, Ngah BA, Rahman RA, et al. The Mentakab hypertension study project. Part V—Drug compliance in hypertensive patients. Singap Med J. 1992; 33(1): 63-66.

    CAS  Google Scholar 

  49. Marin-Reyes F, Rodriguez-Moran M. Family support of treatment compliance in essential arterial hypertension. [Apoyo familiar en el apego al tratamiento de la hipertension arterial esencial.]. Salud Publica Mex. 2001; 43(4): 336-339.

    Article  CAS  PubMed  Google Scholar 

  50. McLane CG, Zyzanski SJ, Flocke SA. Factors associated with medication noncompliance in rural elderly hypertensive patients. Am J Hypertens. 1995; 8(2): 206-209.

    Article  CAS  PubMed  Google Scholar 

  51. Morris AB, Li J, Kroenke K, et al. Factors associated with drug adherence and blood pressure control in patients with hypertension. Pharmacotherapy. 2006; 26(4): 483-492.

    Article  PubMed  Google Scholar 

  52. Ogedegbe G, Schoenthaler A, Fernandez S. Appointment-keeping behavior is not related to medication adherence in hypertensive African Americans. J Gen Intern Med. 2007; 22(8): 1176-1179.

    Article  PubMed Central  PubMed  Google Scholar 

  53. Patel RP, Taylor SD. Factors affecting medication adherence in hypertensive patients. Ann Pharmacother. 2002; 36(1): 40-45.

    Article  PubMed  Google Scholar 

  54. Schoenberg NE. The relationship between perceptions of social support and adherence to dietary recommendations among African-American elders with hypertension. Int J Aging Hum Dev. 1998; 47(4): 279-297.

    Article  CAS  PubMed  Google Scholar 

  55. Schoenthaler A, Chaplin WF, Allegrante JP, et al. Provider communication effects medication adherence in hypertensive African Americans. Patient Educ Couns. 2009; 75(2): 185-191.

    Article  PubMed Central  PubMed  Google Scholar 

  56. Schoenthaler A, Ogedegbe G, Allegrante JP. Self-efficacy mediates the relationship between depressive symptoms and medication adherence among hypertensive African Americans. Health Educ Behav. 2009; 36(1): 127-137.

    Article  PubMed  Google Scholar 

  57. Shea S, Misra D, Ehrlich MH, et al. Correlates of nonadherence to hypertension treatment in an inner-city minority population. Am J Public Health. 1992; 82(12): 1607-1612.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  58. Stanton AL. Determinants of adherence to medical regimens by hypertensive patients. J Behav Med. 1987; 10(4): 377-394.

    Article  CAS  PubMed  Google Scholar 

  59. Stavropoulou C. Perceived information needs and non-adherence: Evidence from Greek patients with hypertension. Health Expect. 2011; 15(2): 187-196.

    Article  PubMed  Google Scholar 

  60. Thorpe CT, Oddone EZ, Bosworth HB. Patient and social environment factors associated with self-blood pressure monitoring by male veterans with hypertension. J Clin Hypertens. 2008; 10(9): 692-699.

    Article  Google Scholar 

  61. Trivedi R, Ayotte B, Edelman D, et al. The association of emotional well-being and marital status with treatment adherence among patients with hypertension. J Behav Med. 2008; 31(6): 489-497.

    Article  PubMed Central  PubMed  Google Scholar 

  62. Warren-Findlow J, Seymour RB, Brunner Huber LR. The association between self-efficacy and hypertension self-care activities among African American adults. J Commun Health. 2012; 37(1): 15-24.

    Article  Google Scholar 

  63. Marshall IJ, Wolfe CDA, McKevitt C. Lay perspectives on hypertension and drug adherence: Systematic review of qualitative research. BMJ. 2012; 345(7867): 1-16.

    Google Scholar 

  64. Gascón JJ, Sánchez-Ortuño M, Llorc B, et al. Why hypertensive patients do not comply with the treatment: Results from a qualitative study. Fam Pract. 2004; 21(2): 125-130.

    Article  PubMed  Google Scholar 

  65. Adair J, Deuschle K, Barnett C. The people’s health: Antropology and medicine in a Navajo community. Albuquerque: University of New Mexico Press; 1989.

    Google Scholar 

  66. Friedson E. Client control and medical practice. Am J Sociol. 1960; 65: 374-382.

    Article  Google Scholar 

  67. Sarason BR, Sarason IG, Pierce GR, eds. Social support: An interactional view. New York: Wiley; 1990.

    Google Scholar 

  68. Hawkley LC, Thisted RA, Masi CM, et al. Loneliness predicts increased blood pressure: Five-year cross-lagged analyses in middle-aged and older adults. Psychol Aging. 2010; 25(1): 132-141.

    Article  PubMed Central  PubMed  Google Scholar 

  69. Hawkley LC, Burleson MH, Berntson GG, et al. Loneliness in every-day life: Cardiovascular activity, psychosocial context, and health behaviors. J Pers Soc Psychol. 2003; 85(1): 105-120.

    Article  PubMed  Google Scholar 

  70. DiMatteo MR, Lepper HS, Croghan TW. Depression is a risk factor for noncompliance with medical treatment meta-analysis of the effects of anxiety and depression on patient adherence. Arch Intern Med. 2000; 160(14): 2101-2107.

    Article  CAS  PubMed  Google Scholar 

  71. Grenard JL, Munjas BA, Adams JL, et al. Depression and medication adherence in the treatment of chronic diseases in the United States: A meta-analysis. J Gen Intern Med. 2011; 26(10): 1175-1182.

    Article  PubMed Central  PubMed  Google Scholar 

  72. Kongkaew C, Jampachaisri K, Chaturongkul CA, et al. Depression and adherence to treatment in diabetic children and adolescents: A systematic review and meta-analysis of observational studies. Eur J Pediatr. 2014; 173(2): 203-212.

    Article  PubMed  Google Scholar 

  73. Lemstra M, Alsabbagh MW. Proportion and risk indicators of nonadherence to antihypertensive therapy: A meta-analysis. Patient Prefer Adherence. 2014; 8: 211-218.

    Article  PubMed Central  PubMed  Google Scholar 

  74. Sin NL, DiMatteo MR. Depression treatment enhances adherence to antiretroviral therapy: A meta-analysis. Ann Behav Med. 2014; 47: 259-269.

    Article  PubMed  Google Scholar 

  75. Morgado MP, Morgado SR, Mendes LC, et al. Pharmacist interventions to enhance blood pressure control and adherence to antihypertensive therapy: Review and meta-analysis. Am J Health Syst Pharm. 2011; 68(3): 241-253.

    Article  PubMed  Google Scholar 

Download references

Authors’ Statement of Conflict of Interest and Adherence to Ethical Standards

Authors Maria Elena Magrin, Marco D’Addario, Andrea Greco, Massimo Miglioretti, Marcello Sarini, Marta Scrignaro, Patrizia Steca, Luca Vecchio, and Elisabetta Crocetti declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. University of Milano-Bicocca, Milano, Italy

    Maria Elena Magrin PhD, Marco D’Addario PhD, Andrea Greco PhD, Massimo Miglioretti MS, Marcello Sarini PhD, Marta Scrignaro PhD, Patrizia Steca PhD & Luca Vecchio PhD

  2. Research Centre Adolescent Development, Utrecht University, Martinus J. Langeveldgebouw, Heidelberglaan 1, 3584CS, Utrecht, The Netherlands

    Elisabetta Crocetti PhD

Authors
  1. Maria Elena Magrin PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marco D’Addario PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Andrea Greco PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Massimo Miglioretti MS
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Marcello Sarini PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Marta Scrignaro PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Patrizia Steca PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Luca Vecchio PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Elisabetta Crocetti PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Elisabetta Crocetti PhD.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Magrin, M.E., D’Addario, M., Greco, A. et al. Social Support and Adherence to Treatment in Hypertensive Patients: A Meta-Analysis. ann. behav. med. 49, 307–318 (2015). https://doi.org/10.1007/s12160-014-9663-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12160-014-9663-2

Keywords

Search

Navigation