Abstract P328: Association of Functional and Structural Social Network Components With Medication Adherence Among Participants With Coronary Heart Disease Risk Factors: the REasons for Geographic and Racial Differences in Stroke Study

Abstract

Prior research suggests that functional (e.g., practical support) social network components are more strongly associated with chronic disease health outcomes than structural (e.g., social network size, frequency of social contacts) components. Yet, it is unclear whether strong social networks help improve health outcomes by promoting medication adherence, particularly among those with coronary heart disease (CHD) risk factors. We included 17,133 black and white adults aged ≥45 years from the REasons for Geographic and Racial Differences in Stroke (REGARDS) study who had diabetes, hypertension, dyslipidemia, or prevalent CHD and used medications for these conditions. Functional (i.e., someone to care for you while sick or disabled vs no-one available) and structural (i.e., presence vs absence of adults in household, married/in a marriage-like relationship vs not partnered, number of close friends and relatives, and number of close friends and relatives seen at least monthly) social network components were self-reported and medication adherence was assessed using the Morisky scale. A weighted composite score was created using the structural components and participants were categorized as reporting high vs low structural support based on the median. Multi-variable adjusted logistic regression models adjusted for demographics, CHD risk factors and cumulative number of medications, were used to estimate the association between functional and structural social network components and medication adherence. Prevalence of high medication adherence was 68.9%. Compared to participants who reported that they had no one to care for them while sick or disabled, participants who reported that someone was available had higher prevalence of medication adherence [OR=1.15 (95% CI: 1.04, 1.26)]. Participants who reported higher structural support (composite score above median) had similar prevalence of medication adherence compared to participants who reported lower structural support [OR=1.09 (95% CI: 0.87, 1.37)]. In conclusion, interventions aimed at providing social support for people with CHD risk factors may need to consider preferentially focusing on enhancing functional aspects of individuals’ social networks as a means of potentially improving medication adherence and ultimately cardiovascular health.