https://orcid.org/0000-0002-2997-6141
Abstract
Introduction
Social support is considered vital for effective management of chronic conditions, but its role in improving adherence to antihypertensive medication and control of hypertension in urban Nepal is unknown. We examined the role of social support in adherence to antihypertensives and controlled blood pressure to inform future interventions for hypertension management.
Methods
We analyzed cross-sectional data collected at baseline of a cluster randomized trial of hypertension patients (n=1252) in the community between May and November 2022. Multidimensional scale of perceived social support was used to measure social support, adherence to antihypertensives was measured using the Morisky medication adherence scale −8, and individuals with systolic- and diastolic- blood pressure less than 140 and 90 mmHg respectively were considered to have controlled hypertension. Modified Poisson regression models were used to estimate the prevalence ratios and corresponding 95% confidence intervals.
Results
We found that 914 (73%) individuals received moderate to high social support. Participants receiving high social support had a numerically lower proportion of controlled hypertension (51%) however not statistically significant. The proportion of good adherence to antihypertensives did not differ between the social support categories. There was no association in overall, family, friends, and significant other sub-scales of social support with controlled hypertension and adherence to antihypertensives.
Discussion
Further studies to understand the quality and mechanisms through which social support contributes to blood pressure control are needed for the health system to include social support in designing and implementing community-based interventions for hypertension management.
Abbreviations
CVDs, Cardiovascular diseases; DAG, Directed acyclic graph; METs, Metabolic equivalents of task; MMAS, Morisky medication adherence scale; MSPSS, Multidimensional scale of perceived social support.
Data Sharing Statement
Data cannot be shared publicly for ethical reasons but are available on reasonable request to Ms Sanju Bhattarai and Dr Abhijit Sen.
Acknowledgments
We would like to thank all the participants in the study. We would like to thank field researchers Ms Apsara Basnet, Ms Geeta Tripathi, Ms Pema Tamang, Ms Prasoon Pandey, Mr Kishore Adhikari, Ms Sarita Bhandari, Ms Supriya Kharel.
The MMAS-8 Scale, content, name, and trademarks are protected by US copyright and trademark laws. Permission for use of the scale and its coding is required. A license agreement is available from MMAR, LLC., www.moriskyscale.com.
Disclosure
The authors declare that they have no competing interests in this work.