The Effect of Social Support on Treatment Adherence in Hypertension in China

Figures & data

Figure 1 Flowchart of inclusion of hypertensive patients.

Notes: The patients hospitalized in Xi’an People’s Hospital (Xi’an Fourth Hospital) between January and May 2021 were selected according to the inclusion criteria. Four hundred and eighty-seven hypertensive patients were randomly selected, of which 11 patients cannot be contacted and 23 patients did not want to participate. Finally, 453 hypertensive patients were recruited.

Table 1 Sociodemographic and Clinical Characteristics of Hypertension Patients (n=453)

Characteristics		Frequency (n)	Percentage (%)
Age(years)	<50	48	10.60
	50–69	241	53.20
	≥70	164	36.20
Gender	Female	232	51.21
	Male	221	48.79
Residence	Rural	159	35.10
	Urban	294	64.90
Education level	Illiterate	17	3.75
	Primary	80	17.66
	High school	252	55.63
	College/University	104	22.96
Living condition	Live alone	40	8.83
	Living with family	413	91.17
Number of children	≤1	179	39.51
	2 or 3	218	48.12
	≥4	56	12.36
Occupation status	Unemployed	138	30.46
	Employed	68	15.01
	Retired	247	54.53
Health insurance	Urban medical insurance	240	52.98
	Rural medical insurance	95	20.97
	No medical insurance	118	26.05
BP categories	Grade I Hypertension	29	6.40
	Grade II Hypertension	189	41.72
	Grade III Hypertension	235	51.88
Duration of HTN (years)	<5	141	31.13
	5–9	83	18.32
	10–19	132	29.14
	≥20	97	21.41
Duration of antihypertensive drugs used (years)	<5	168	37.09
	5–9	100	22.08
	10–19	127	28.04
	≥20	58	12.80
Number of antihypertensive drugs used	1	294	64.90
	2	153	33.77
	≥3	6	1.32

Abbreviations: BP, blood pressure; HTN, hypertension.

Table 2 Factors Associated with Optimal Adherence (n=453)

Variables	Adherence n(%)	Non Adherence n(%)	P-value
Age(years)			<0.001
<50	2 (4.17)	46 (95.83)
50–69	56 (23.24)	185 (76.76)
≥70	83 (50.61)	81 (49.39)
Gender			0.001
Female	88 (37.93)	144 (62.07)
Male	53 (23.98)	168 (76.02)
Residence			<0.001
Rural	33 (20.75)	126 (79.25)
Urban	108 (36.73)	186 (63.27)
Education level			0.175
Illiterate	9 (52.94)	8 (47.06)
Primary	28 (35.00)	52 (65.00)
High school	74 (29.37)	178 (70.63)
College/University	30 (28.85)	74 (71.15)
Living condition			0.104
Live alone	17 (42.50)	23 (57.50)
Living with family	124 (30.02)	289 (69.98)
Number of children			<0.001
≤1	41 (22.91)	138 (77.09)
2 or 3	71 (32.57)	147 (67.43)
≥4	29 (51.79)	27 (48.21)
Occupation status			<0.001
Unemployed	29 (21.01)	109 (78.99)
Employed	9 (13.24)	59 (86.76)
Retired	103 (41.70)	144 (58.30)
Health insurance			0.014
Urban medical insurance	89 (37.08)	151 (62.92)
Rural medical insurance	24 (25.26)	71 (74.74)
No medical insurance	28 (23.73)	90 (76.27)
BP categories			0.064
Grade I Hypertension	5 (17.24)	24 (82.76)
Grade II Hypertension	53 (28.04)	136 (71.96)
Grade III Hypertension	83 (35.32)	152 (64.68)
Duration of HTN (years)			<0.001
<5	26 (18.44)	115 (81.56)
5–9	18 (21.69)	65 (78.31)
10–19	50 (37.88)	82 (62.12)
≥20	47 (48.45)	50 (51.55)
Duration of antihypertensive drugs used (years)			<0.001
<5	31 (18.45)	137 (81.55)
5–9	27 (27.00)	73 (73.00)
10–19	49 (38.58)	78 (61.42)
≥20	34 (58.62)	24 (41.38)
Number of antihypertensive drugs used			<0.001
1	62 (21.09)	232 (78.91)
2	75 (49.02)	78 (50.98)
≥3	4 (66.67)	2 (33.33)
Social support total score (mean, SD)	37.26 ± 2.39	33.64± 3.78	<0.001

Abbreviations: BP, blood pressure; HTN, hypertension; SD, standard deviation; P, probability.

Table 3 Binary Logistic Regression Analysis of Factors Associated with Adherence in Hypertensive Patients

Variables	OR (95% Cl)	P-value
Gender
Female	1.000	–
Male	2.041(1.210–3.443)	0.008
Duration of antihypertensive drug used (years)	0.917(0.851–0.987)	0.021
Number of antihypertensive drugs used	0.509(0.310–0.836)	0.008
Social support	0.752(0.678–0.833)	<0.001

Abbreviations: OR, odds ratio; Cl, confidence interval; P, probability.

Table 4 Scale Average Scores of Participants

Scales and Subgroups	Obtained Average Score (Mean ± SD)	Obtained Minimum and Maximum Values
HBTS	44.25 ± 5.38	14–56
CFSS	34.77 ± 3.79	12–60
Kinship	9.39 ± 1.68	4–20
1.Your parents	1.38±0.72	1–5
2.Your spouse or partner’s parents	1.35±0.66	1–5
3.Your relatives	3.40±0.93	1–5
4.Your spouse or partner’s relatives	3.30±0.94	1–5
Nuclear family	8.54 ± 1.85	2–10
5.Spouse or partner	4.12±1.45	1–5
8.Your children	4.38±0.89	1–5
Social resources	16.83 ± 2.60	6–30
6.Your friends	2.88±0.60	1–5
7.Your spouse or partner’s friends	2.72±0.58	1–5
9. Co workers	2.49±0.62	1–5
10.Community organizations	2.78±0.72	1–5
11.Professional agencies	3.84±0.94	1–5
12.Other social organizations	2.13±0.39	1–5

Abbreviations: HBTS, hill-bone compliance to high blood pressure therapy scale; CFSS, The Chinese Family Support Scale; SD, standard deviation.

Table 5 Spearman Correlation Analysis Among the HBTS and CFSS and Their Subgroups

Scales	HBTS (Total Score)		Reduced Sodium Intake		Appointment Keeping		Medication Taking
	r	P	r	P	r	P	r	P
CFSS (total score)	0.638	<0.001	0.472	<0.001	0.367	<0.001	0.603	<0.001
Social support from kinship	0.364	<0.001	0.239	<0.001	0.184	<0.001	0.354	<0.001
Social support from nuclear family	0.262	<0.001	0.237	<0.001	0.021	>0.05	0.249	<0.001
Social support from social resources	0.568	<0.001	0.369	<0.001	0.411	<0.001	0.529	<0.001

Abbreviations: HBTS, hill-bone compliance to high blood pressure therapy scale; CFSS, The Chinese Family Support Scale; P, probability.