Why Experts Say Social Support Should Be Part of Your Next Prescription

Receiving a severe diagnosis from a doctor can feel lonely and isolating. But what if the treatment prescribed social support, like group meetings and family sessions?

Timothy Smith, PhD and Julianne Holt-Lunstad, PhD, both Brigham Young University professors in Utah, collaborated with researchers and students to analyze 106 studies on the effects of social support interventions on survival. They found that for medical conditions that result in death if left untreated (like cardiovascular disease and cancer), integrating social support into treatment plans helped people survive at higher rates and live longer.

Holt-Lunstad said in a press release that these findings show social needs should be addressed within medical settings. The research was published in the journal PLOS Medicine in mid-May.

"It turns out that your overall social networks predict your longevity just as much as smoking 15 cigarettes a day," Smith tells Verywell. He adds, in terms of predicting how long you'll live, social support is a greater factor than alcoholism, obesity, high blood pressure, high cholesterol—"more than any typical metric you might think of."

For this meta-analysis, researchers wanted to see if it was possible to prescribe social support. A doctor can't do anything about a patient's already-existing family structure or friends per se, Smith says, "so the question became, 'Can medicine intervene?' And the answer is, 'Yes, 100%.' The bottom line take-home message is, medical care improves patient survival when social and emotional factors are explicitly taken into account by healthcare providers."

What Did the Interventions Look Like?

Researchers analyzed the data from 106 randomized controlled trials, including over 40,000 patients in majority outpatient settings. The most common medical conditions participants were treated for were cardiovascular disease and cancer.

The studies included also reported medical patients’ survival as a result of interventions that provided psychological, emotional, and/or social support. 

Examples of support include:

• In-person group meetings
• Telephone/online sessions
• Home visits
• In-person individual sessions

Interventions were done by nurses or medical staff and mental health professionals in most studies. Some involved interventions by peers with the same medical condition or family members. Over the course of about seven months, patients typically had 15 sessions lasting about an hour and a half. Researchers usually followed participants for more than two years.

They found that in most of the studies, there was an average 20% increased likelihood of survival among patients receiving psychosocial support compared to control groups receiving standard medical care.

In those studies, interventions that explicitly promoted health behaviors worked best. These interventions included motivating patients to exercise, and encouraging them to adhere to medical treatments or to follow a prescribed diet.

In the 22 studies that reported survival time, there was a 29% increased chance of survival for participants that received interventions. Overall, interventions mostly focusing on patients’ social or emotional outcomes did not prolong life as much as those that promoted health behaviors.

Social Support in Action

Smith says social support can have a big impact on your overall health.

For example, he says, when people think they're ill, they might be nervous and not even sure if going to the doctor will help, so many avoid going. "Number one, if you have social support, it gets you to the doctor in the first place," he says. "If someone says, 'Hey, you don't look well,' then you might start taking it seriously."

Once you're at the doctor's office, Smith adds, having someone there with you helps. "Research shows that patients remember 20% of what a physician says," he says. "But if you have someone with you, they can take notes, and they can also hold you accountable." Whether it's reminding you to take your medicine or do the recommended exercises, they can help you carry out what you were actually prescribed, and improve your likelihood of survival.

Study Limitations

In these studies, those who had more severe diseases were less likely to benefit. And only a minority of the studies had participants' family members or friends carry out interventions, even though evidence suggests that support from these very people may produce "longer-lasting effects," the authors write. Receiving support from medical staff just might not help in the same ways, Smith says.

Future researchers will need to investigate how the length of time and quantity of this support affects its benefits. If these interventions are given over a longer period of time, for example, and offered at an earlier stage in the disease, they could potentially improve survival rates even more.

How to Incorporate Support Into Health Care

Actually incorporating this support into healthcare systems remains challenging.

"Getting the word out to healthcare in general, and to insurance companies in particular, to start paying for these interventions is the next step," Smith says. "Patient lives can be saved. It's just that there's a gap. The doctor can tell you to take a pill all day long, but do you actually do it? That's the gap."

Physicians can provide treatments, advice, and prescriptions to patients, but they don't often evaluate the likelihood that the patient will actually follow through. "Our data indicate that explicitly fostering patients’ motivation, coping strategies, social support, etc. improves their survival," Smith says.

Because of this, the study authors recommend the following:

• Protocols for evaluating existing sources of patient support along with barriers to treatment completion
• Hospital/clinic support programs for patients, particularly those at risk for not completing treatments, with family/caregivers included in the programs for additional support and accountability
• Ways of making hospitals/clinics more “family/caregiver friendly” (for patients who desire that support and provide written consent)
• Improved training in medical schools to address patient social/emotional/behavioral considerations
• Integration of psychosocial factors in pre-surgery/intervention planning, post-surgery/intervention follow-up, and rehabilitation programs
• Increased collaboration between medical professionals and mental health professionals

These recommendations arrive at a time when the entire healthcare system is shifting to incorporate psychological considerations, Smith notes. Psychologists are also increasingly helping with conditions such as cancer, ulcers, and chronic pain, and are routinely hired to consult with physicians and to work with patients.

"We're completely amazed at how much social support, particularly your intimate relationships," Smith says, such as family and friends, can help. "Anything public health can do to strengthen family cohesion for medical patients will benefit those patients long-term."