title: Practical support predicts medication adherence and attendance at cardiac rehabilitation following acute coronary syndrome.
abstract: OBJECTIVE
  Poor social support is associated with recurrent cardiac events following acute coronary syndrome (ACS). Interventions have largely targeted emotional support, but practical support may be particularly important in encouraging recovery behaviors. We assessed whether practical and emotional support differentially predicted medication adherence and rehabilitation attendance following ACS.
  
  
  METHODS
  This prospective observational clinical cohort study involved 262 survivors of verified ACS, recruited from four coronary care units in the London area. Practical and emotional support were measured in hospital, and depression, 7-10 days after discharge. Medication adherence and rehabilitation attendance were assessed by telephone interview 12 months after hospitalization.
  
  
  RESULTS
  Nearly one third of patients (29.8%) had no practical supports, 16% had one, and 54.2% had two or more sources of practical support. Patients with greater practical support were more likely to adhere to medication (P=.034) independently of age, gender, marital status, clinical risk profile, and depression. There was also an association with rehabilitation attendance (P=.034), but this was no longer significant after depression had been taken into account. Emotional support was unrelated to medication adherence and rehabilitation attendance.
  
  
  CONCLUSIONS
  Cardiac patients with greater practical support may receive more prompts about medications, help with filling prescriptions and assistance with cardiac rehabilitation attendance. These behaviors can influence long-term recovery.
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, UK. g.molloy@ucl.ac.uk
authors.forename: Gerard J
authors.initials: GJ
authors.lastname: Molloy
authors.forename: Linda
authors.initials: L
authors.lastname: Perkins-Porras
authors.forename: Mimi R
authors.initials: MR
authors.lastname: Bhattacharyya
authors.forename: Philip C
authors.initials: PC
authors.lastname: Strike
authors.forename: Andrew
authors.initials: A
authors.lastname: Steptoe
mesh_terms: D054058:Acute Coronary Syndrome / Q000188:drug therapy* / Q000534:rehabilitation; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003325:Coronary Care Units; D005260:Female; D006760:Hospitalization; D006801:Humans; D008131:London; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D010349:Patient Compliance; D012047:Rehabilitation Centers / Q000706:statistics & numerical data; D012944:Social Support; D017741:Survivors / Q000523:psychology