Older adults with diabetes participating in the Supplemental Nutrition Assistance Program, or SNAP, demonstrated improvements in adhering to their treatment regimens, according to findings published in JAMA Internal Medicine.
“Understanding if the association of social programs with health care access and utilization, especially among older adults with costly chronic medical conditions, can help in improving strategies for self-management of disease” is imperative, Jennifer A. Pooler, MPP, and Mithuna Srinivasan, PhD, both from IMPAQ International LLC, wrote.
Pooler and Srinivasan conducted a cross-sectional, population-based study to determine if low-income adults aged 65 years or older with diabetes who participate in SNAP were less likely to need to forgo medications due to cost compared with nonparticipants. The researchers enrolled 1,302 older adults (33.3% men; 55% non-Hispanic white; 44.6% aged 75 years or older) from the 2013 to 2016 National Health Interview Survey.
A total of 503 participants were participating in SNAP. Participants in SNAP were matched to eligible nonparticipants based on sociodemographic and health and health care-related characteristics of individuals.
Cost-related medication nonadherence was determined based on responses to survey questions that asked participants if they delayed refilling a medication, took less medication and skipped medication doses due to cost in the past year.
Overall, 12.9% (n = 178) of participants in SNAP reported cost-related medication nonadherence in the past year. There was a moderate decrease in cost-related medication nonadherence among participants in SNAP compared with eligible nonparticipants (5.3 percentage point reduction; 95% CI, 0.5-10 percentage point reduction). Subgroups that had prescription drug coverage (5.8 percentage point reduction; 95% CI, 0.6-11) and less than $500 in out-of-pocket medical costs in the previous year (6.4 percentage point reduction; 95% CI, 0.8-11.9) demonstrated similar reductions in cost-related medication nonadherence. However, older adults who lacked prescription coverage or had higher medical costs did not show such reductions.
“The study findings suggest that even though SNAP is designed to alleviate hunger by providing financial resources to purchase food, the program may also allow individuals to better afford medications,” Pooler and Srinivasan concluded. “This benefit, in turn, may be associated with an improvement in overall health and reduction in the burden of high costs faced by health systems. For low-income older patients with diabetes, in particular, these findings offer a potential strategy for improving health outcomes and reducing hypoglycemia: linking patients with social service programs that can help address financial hardship.” – by Alaina Tedesco
Disclosures: The authors report no relevant financial disclosures.