Interactive effects of social support and social conflict on medication adherence in multimorbid older adults
Warner, LM and Schuz, B and Aiken, L and Ziegelmann, JP and Wurm, S and Tesch-Romer, C and Schwarzer, R, Interactive effects of social support and social conflict on medication adherence in multimorbid older adults, Social Science & Medicine, 87, (2013) pp. 23-30. ISSN 0277-9536 (2013) [Refereed Article]
With increasing age and multimorbidity, medication regimens become demanding, potentially resulting in suboptimal adherence. Social support has been discussed as a predictor of adherence, but previous findings are inconsistent. The study examines general social support, medication-specific social support, and social conflict as predictors of adherence at two points in time (6 months apart) to test the mobilization and social conflict hypotheses. A total of 309 community-dwelling multimorbid adults (65–85 years, mean age 73.27, 41.7% women; most frequent illnesses: hypertension, osteoarthritis and hyperlipidemia) were recruited from the population-representative German Ageing Survey. Only medication-specific support correlated with adherence. Controlling for baseline adherence, demographics, physical fitness, medication regimen, and attitude, Time 1 medication-specific support negatively predicted Time 2 adherence, and vice versa. The negative relation between earlier medication-specific support and later adherence was not due to mobilization (low adherence mobilizing support from others, which over time would support adherence). Social conflict moderated the medication-specific support to adherence relationship: the relationship became more negative, the more social conflict participants reported. Presence of social conflict should be considered when received social support is studied, because well-intended help might have the opposite effect, when it coincides with social conflict.
medication adherence, social support, older adults, multimorbidity