Association between different types of social support and medication adherence.

OBJECTIVES To evaluate the association between social support and medication adherence. STUDY DESIGN A search of articles published before November 2010 in peer-reviewed, healthcare-related journals was conducted using PubMed, EMBASE, and Web of Science, and search terms related to social support (social support OR friend OR family OR agency) and adherence (patient compliance OR medication adherence), yielding 5331 articles. METHODS Articles were included if they directly measured the relationship between medication adherence and some form of social support. Excluded were case studies, studies with participants < 18 years of age, and non-English language studies. Four social support categories were reported: structural, practical, emotional, and combination. Medication adherence was reported in the manner in which it was described in each study. RESULTS Fifty studies were included in the final analysis. A greater degree of practical support was most consistently associated with greater adherence to medication; evidence for structural or emotional support was less compelling. However, most studies were limited in size and design, and substantial variability in designs and outcome measurement prohibited pooling of results, necessitating qualitative evaluation of the studies. CONCLUSIONS This qualitative analysis found that practical social support was most consistently associated with greater medication adherence. Interventions that use existing contacts (friends or family) to engage patients in the mundane and practical aspects of medication purchasing and administration may be an effective approach to promoting better medication adherence.