Background: Although social support is used to determine eligibility, the relationship between social support and nonadherence remains unclear. We examined the predictive value of social support for medication nonadherence.

Methods: Ten databases (e.g.PubMed, MEDLINE, PsychInfo, Cochrane) were searched from inception through 2015. Selected studies investigated the association between social support and medication nonadherence (self-report, electronic, labs, physician reported). Social support included marital status, received, or perceived support. Two reviewers independently extracted data and assessed study quality. Odds ratios and correlations were calculated. Effect sizes were pooled using random effects model.

Results: The 20 eligible studies (6 prospective and 14 retrospective, published 1993 -2015) included 3529 participants. Sample sizes varied from 37 to 544. Follow-up time ranged from 6 to 84 months post-transplant. Eleven studies examined marital status and nonadherence (OR=1.50; CI: 1.19, 1.89). Associations varied by organ: heart (OR=2.14; CI 1.03, 4.45), kidney (OR=1.74; CI: 1.28, 2.38); and liver (OR=1.13; CI 0.85, 1.50). Eighteen studies examined social support and nonadherence (OR=1.06; CI: 0.98, 1.15). Associations varied by organ: heart (OR=1.22; CI 0.99, 1.51), kidney (OR=1.29, CI: 0.93, 1.79), and liver (OR=1.31; CI 0.92, 1.86).

Limitations: Observational studies and heterogeneity in definitions and assessments.

Conclusion: Marital status increased adherence modestly; received and perceived social support were non-predictive. Use of social support as a contraindication should be re-examined.

CITATION INFORMATION: Ladin K, Daniels A, Bannuru R, Osani M. Social Support Does Not Predict Medication Adherence Post-Transplantation: A Systematic Review and Meta-Analysis. Am J Transplant. 2016;16 (suppl 3).

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