Is there an association between perceived social support and cardiovascular health behaviours in people with severe mental illnesses?

Abstract

Purpose People with severe mental illnesses (SMI) have an increased risk of cardiovascular disease (CVD). Research in the general population suggests that social support may protect against increased CVD morbidity and mortality; however, this may not apply to those with SMI. We aimed to explore the association between perceived social support and attendance at primary care nurse CVD risk reduction clinic appointments and CVD risk-reducing behaviours in an SMI population with elevated CVD risk factors. Methods We used longitudinal and cross-sectional data from a randomised controlled trial on 326 adults with SMI recruited via 76 general practices in England. Multilevel regression analysis estimated the effect of perceived social support on attendance at CVD risk reduction clinic appointments over 6 months, and adherence to CVD medication, physical activity, diet, smoking and alcohol use at baseline, adjusted by age, sex, ethnicity, deprivation, psychiatric diagnosis and employment. Results Perceived social support predicted greater appointment attendance in unadjusted (IRR = 1.005; 1.000–1.010; p = 0.05) but not adjusted analysis (IRR = 1.003; 0.998–1.009; p = 0.25). Perceived social support was associated with greater adherence to medication; for each 1% increase in social support, there was a 4.2% increase in medication adherence (OR = 1.042; 1.015–1.070; p = 0.002). No association was found between greater perceived social support and greater physical activity, lower sedentary behaviour, healthier diet, lower alcohol use or being a non-smoker. Conclusions Social support may be an important facilitator for CVD medication adherence and is potentially important for primary care appointment attendance; however, alternative strategies might be needed to help people with SMI engage in physical activity, healthier diets and to reduce their smoking and alcohol use.

Pattern and causes of missed appointments in a Nigerian Psychiatric Hospital: A cross-sectional study

“…Consistent with previous research, social support was not associated with missing appointments, but this was somewhat unexpected. [37][38][39] Family support reduces relapse and improves clinical outcomes. [40] Our instrument may not have captured the specific aspects of social support crucial for treatment adherence.…”

Medication Adherence in Cardiovascular Diseases

“…schizophrenia and bipolar disorder), perceived social support improved adherence to CVD medication. There was a 4.2% increase in medication adherence for each 1% increase in social support (OR 1.04, 95% CI 1.02-1.07, P = 0.002) [92]. In an HF setting, a prospective cohort study in Taiwan showed an intimate relationship with a spouse or caregiver was associated with a lower risk of 18-month all-cause readmission and cardiac readmission.…”

An integrated primary care service to reduce cardiovascular disease risk in people with severe mental illness: Primrose-A. Thematic analysis of its acceptability, feasibility, and implementation.

“…Whilst this can be partially attributed to SMI-related deaths including suicide, physical comorbidities are estimated to cause approximately 60% of this mortality gap (1,2). appointment attendance (19). Therefore, potential enhancements to improve physical outcomes would be to integrate an emphasis on statins and expand the potential for social support through the intervention.…”