The association between social integration  and support, medication adherence and  gender among transplant recipients

Background: Organ transplantation recipients have been shown to struggle with medication adherence, which has severe consequences on their health. Research on medication non-adherence has demonstrated an inconsistent relationship between social integration and support (SIS) and adherence. Two theories can be used to explain a positive association between SIS and adherence. Firstly, according to the Self-Determination Theory, SIS can influence intrinsic motivation, further influencing adherence. Secondly, the Buffer Hypothesis states that high SIS can buffer the impact of negative life experiences that increase non-adherence. Additionally, some studies have suggested that the relationship between SIS and adherence is different for men and women. Aims: The current study studied the effect of SIS on adherence, hypothesizing that higher SIS would be related to adherence. The second hypothesis was that this effect would be stronger among men compared to women. Methods: To investigate the...Show moreBackground: Organ transplantation recipients have been shown to struggle with medication adherence, which has severe consequences on their health. Research on medication non-adherence has demonstrated an inconsistent relationship between social integration and support (SIS) and adherence. Two theories can be used to explain a positive association between SIS and adherence. Firstly, according to the Self-Determination Theory, SIS can influence intrinsic motivation, further influencing adherence. Secondly, the Buffer Hypothesis states that high SIS can buffer the impact of negative life experiences that increase non-adherence. Additionally, some studies have suggested that the relationship between SIS and adherence is different for men and women. Aims: The current study studied the effect of SIS on adherence, hypothesizing that higher SIS would be related to adherence. The second hypothesis was that this effect would be stronger among men compared to women. Methods: To investigate the hypotheses in a cross-sectional study, transplant recipients completed questionnaires about their SIS (Health Education Impact Questionnaire) and medication adherence (Basel Assessment of Adherence to Immunosuppressive Medication Scale). Recipients were recruited from seven transplant departments of five University Medical Centres. Analyses of the following associations were conducted using logistic regression: (1) SIS and medication adherence, (2) SIS and medication adherence with gender as a covariate. Results: Overall, 168 transplant recipients completed the questionnaires. The mean age was 53.87 (SD: 13.8), most participants were male (62.5%) and 17% of the patients were considered medication non-adherent. There was no significant association between SIS and adherence, (OR = 0.955, 95% CI [0.472 – 1.933). This effect was not significantly influenced by gender, (OR = 0.83, 95% CI [0.149 – 4.624]. Conclusion: No significant associations between SIS, gender and medication adherence were reported. A possible explanation for these findings is that other moderating and mediating factors exist and that the relationship between SIS and medication adherence is more complicated than this study was able to examine. Alternatively, the type of SIS studied was not specific enough to be associated with adherence. Future studies should investigate the factors that influence medication adherence and specify the type of SIS that is crucial for increasing medication adherenceShow less

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The association between social integration and support, medication adherence and gender among transplant recipients