PERCEIVED ADEQUACY OF TANGIBLE SOCIAL SUPPORT AND HEALTH OUTCOMES IN PATIENTS WITH CORONARY-ARTERY DISEASE

OBJECTIVE: Health outcomes of patients with chronic disease might be i nfluenced by assistance from others in performing daily activities. We examined whether perceived adequacy of such tangible support was asso ciated with prognosis in a cohort of patients with coronary artery dis ease. DESIGN: Longitudinal cohort study. SETTING/PARTICIPANTS: In spri ng 1993, a cohort of 1,468 patients with chronic artery disease was id entified using claims data. The cohort consisted of all surviving resi dents of Manitoba, Canada, who had been hospitalized for acute myocard ial infarction from 1991 to 1992: 820 patients completed the initial s urvey, and 734 completed a follow-up survey approximately 1 year later . MEASUREMENTS AND MAIN RESULTS: Adequacy of tangible support was asse ssed by asking if respondents needed help at home because of health pr oblems, and whether these needs were met. We examined the association between perceived adequacy of tangible support and health outcomes at 1 year (mortality, physical function). Of 820 participants, 74% percei ved no need for help, 13% had sufficient help, 9% needed more help, an d 5% needed much more help; 31 patients died during follow-up. After a djustment for age and initial health status, odds ratios (95% confiden ce interval) for death were: sufficient help 1.8 (0.61, 5.8); need mor e help 3.2 (1.1, 9.4); and need much more help 6.5 (2.0, 21.6) compare d with respondents with no perceived need. Decline in physical functio n was also Linearly related to perceiving less-adequate tangible suppo rt. Sensitivity analyses indicated it is highly improbable that result s were due to selection bias. CONCLUSIONS: Perceived lack of needed as sistance was related to mortality and to decline in physical functioni ng. Adequacy of tangible support was an important prognostic factor fo r these patients with coronary artery disease and may be a determinant of health outcomes.