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Social support, social context and nonadherence to treatment in young senior patients with multimorbidity and polypharmacy followed-up in primary care. MULTIPAP Study

Author

Listed:
  • Cristina M Lozano-Hernández
  • Juan A López-Rodríguez
  • Francisca Leiva-Fernández
  • Amaia Calderón-Larrañaga
  • Jaime Barrio-Cortes
  • Luis A Gimeno-Feliu
  • Beatriz Poblador-Plou
  • Isabel del Cura-González
  • MULTIPAP GROUP

Abstract

Objective: To estimate the prevalence of nonadherence to treatment and its relationship with social support and social context in patients with multimorbidity and polypharmacy followed-up in primary care. Methods: This was an observational, descriptive, cross-sectional, multicenter study with an analytical approach. A total of 593 patients between 65–74 years of age with multimorbidity (≥3 diseases) and polypharmacy (≥5 drugs) during the last three months and agreed to participate in the MULTIPAP Study. The main variable was adherence (Morisky-Green). The predictors were social support (structural support and functional support (DUFSS)); sociodemographic variables; indicators of urban objective vulnerability; health-related quality of life (EQ-5D-5L-VAS & QALY); and clinical variables. Descriptive, bivariate and multivariate analyses with logistic regression models and robust estimators were performed. Results: Four out of ten patients were nonadherent, 47% had not completed primary education, 28.7% had an income ≤1050 €/month, 35% reported four or more IUVs, and the average perceived health-related quality of life (HRQOL) EQ-5D-5L-VAS was 65.5. The items that measure functional support, with significantly different means between nonadherent and adherent patients were receiving love and affection (-0.23; 95%CI: -0.40;-0.06), help when ill (-0.25; 95%CI: -0.42;-0.08), useful advice (-0.20; 95%CI: -0.37;-0.02), social invitations (-0.22; 95%CI:-0.44;-0.01), and recognition (-0.29; 95%CI:-0.50;-0.08). Factors associated with nonadherence were belonging to the medium vs. low tertile of functional support (0.62; 95%CI: 0.42;0.94), reporting less than four IUVs (0.69; 95%CI: 0.46;1.02) and higher HRQOL perception (0.98; 95%CI: 0.98;0.99). Conclusions: Among patients 65–74 years of age with multimorbidity and polypharmacy, lower functional support was related to nonadherence to treatment. The nonadherence decreased in those patients with higher functional support, lower urban vulnerability and higher perceived health status according to the visual analog scale of health-related quality of life.

Suggested Citation

  • Cristina M Lozano-Hernández & Juan A López-Rodríguez & Francisca Leiva-Fernández & Amaia Calderón-Larrañaga & Jaime Barrio-Cortes & Luis A Gimeno-Feliu & Beatriz Poblador-Plou & Isabel del Cura-Gonzál, 2020. "Social support, social context and nonadherence to treatment in young senior patients with multimorbidity and polypharmacy followed-up in primary care. MULTIPAP Study," PLOS ONE, Public Library of Science, vol. 15(6), pages 1-15, June.
    • Handle: RePEc:plo:pone00:0235148
    DOI: 10.1371/journal.pone.0235148
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    References listed on IDEAS

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    1. Favel L Mondesir & April P Carson & Raegan W Durant & Marquita W Lewis & Monika M Safford & Emily B Levitan, 2018. "Association of functional and structural social support with medication adherence among individuals treated for coronary heart disease risk factors: Findings from the REasons for Geographic and Racial," PLOS ONE, Public Library of Science, vol. 13(6), pages 1-13, June.
    2. Donovan, Jenny L. & Blake, David R., 1992. "Patient non-compliance: Deviance or reasoned decision-making?," Social Science & Medicine, Elsevier, vol. 34(5), pages 507-513, March.
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