Stress, depression and medication nonadherence in diabetes: test of the exacerbating and buffering effects of family support

• Published in: Journal of behavioral medicine Vol. 38; no. 2; pp. 363 - 371
• Main Authors: Mayberry, Lindsay Satterwhite, Egede, Leonard E., Wagner, Julie A., Osborn, Chandra Y.
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01.04.2015; Springer; Springer Nature B.V
• Subjects: Care and treatment; Depression (Mood disorder); Depression - complications; Depression - psychology; Development and progression; Diabetes; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - psychology; Family - psychology; Family Medicine; Female; General Practice; Health Psychology; Humans; Hypotheses; Male; Medication Adherence - psychology; Medicine; Medicine & Public Health; Mental depression; Middle Aged; Minority & ethnic groups; Patient compliance; Patient outcomes; Pharmacists; Premature mortality; Risk factors; Social Class; Social Support; Type 2 diabetes; United States; United States > US; Nashville Tennessee; Medication adherence; Depression; Stress/stressors; Diabetes; Family support; Social support
• ISSN: 0160-7715; 1573-3521
• DOI: 10.1007/s10865-014-9611-4

Stressors and depressive symptoms have been associated with medication nonadherence among adults with type 2 diabetes (T2DM). We tested whether these associations were exacerbated by obstructive family behaviors or buffered by supportive family behaviors in a sample of 192 adults with T2DM and low socioeconomic status using unadjusted and adjusted regression models. We found support for the exacerbating hypothesis. Stressors and nonadherence were only associated at higher levels of obstructive family behaviors (interaction AOR = 1.12, p  = .002). Similarly, depressive symptoms and nonadherence were only associated at higher levels of obstructive family behaviors (interaction AOR = 3.31, p  = .002). When participants reported few obstructive family behaviors, neither stressors nor depressive symptoms were associated with nonadherence. We did not find support for the buffering hypothesis; stressors and depressive symptoms were associated with nonadherence regardless of supportive family behaviors. Nonadherent patients experiencing stressors and/or major depressive symptoms may benefit from interventions that reduce obstructive family behaviors.