SNAP Participation Tied to Better Medication Adherence in Elders With T2DM

By Anne Harding

NEW YORK (Reuters Health) - Older adults with diabetes who participate in the Supplemental Nutrition Assistance Program (SNAP) are at about 30% lower risk of cost-related medication non-adherence, according to new research.

"Safety-net programs like SNAP can help people with chronic conditions better afford other necessities" in addition to food, such as medication and utility bills, Jennifer A. Pooler of IMPAQ International in Columbia, Maryland, a co-author of the study, told Reuters Health by phone.

Annual medical costs for older adults with diabetes are about $11,825, with about 18% spent on prescription medication, Dr. Pooler and her IMPAQ International colleague Dr. Mithuna Srinivasan note in JAMA Internal Medicine, online November 19.

"Unaffordable health care costs can result in tradeoffs between basic needs such as food and medication, and these tradeoffs can be particularly challenging for low-income adults with diabetes because both food and medication must be addressed to effectively manage the disease," they add.

Recent research suggests that SNAP - the biggest food-safety-net program in the U.S. - may lower healthcare costs, possibly by reducing cost-related medication non-adherence, the authors note.

To investigate, they looked at 1,302 men and women age 65 and older who participated in the National Health Interview Survey in 2013-2016. For the previous year, 36.3% reported participating in SNAP and 12.8% engaged in cost-related medication non-adherence.

SNAP participants were 5.3 percentage points less likely to report cost-related medication non-adherence than those who did not receive SNAP (P=0.03).

An estimated 16.8% of the non-SNAP group had reported non-adherence due to cost, so the 5.3 percentage point decrease was equivalent to a 31.5% reduction in non-adherence in the SNAP group.

Among study participants with prescription-drug coverage, SNAP was associated with a 5.8 percentage point decrease in non-adherence (P=0.03). For older adults who spent less than $500 out-of-pocket for medical costs, non-adherence decreased by 6.4 percentage points (P=0.02).

SNAP was not associated with better adherence in people who spent more out-of-pocket or didn’t have prescription coverage.

"This study supports previous findings that suggest that enrollment in SNAP can serve as a strategy for supporting glycemic control among low-income adults with diabetes," the authors conclude.

Nearly 60% of adults 65 and older who are eligible for SNAP are not receiving it, Pooler said. She and her colleagues plan to investigate whether other safety-net programs may improve health outcomes in older people.

SOURCE: https://bit.ly/2A82RPn

JAMA Intern Med 2018.

(c) Copyright Thomson Reuters 2018. Click For Restrictions - https://agency.reuters.com/en/copyright.html

For more Pharmacy Learning Network articles, visit the homepage

To learn about Pharmacy Learning Network Live meetings, click here