College of Health Solutions, Arizona State University, Phoenix, AZ, USA.
Harry S Truman School of Government and Public Affairs, University of Missouri, Columbia, MO, USA.
J Gen Intern Med. 2023 May;38(6):1349-1356. doi: 10.1007/s11606-022-07994-4. Epub 2023 Jan 27.
Food insecurity has been associated with medication non-adherence among individuals living with chronic diseases like hypertension. The relationship between Supplemental Nutrition Assistance Program (SNAP)-a public program that addresses food insecurity-and Medication adherence among older Medicaid-insured adults living with hypertension is not clear.
To analyze the association between patterns of SNAP participation and adherence to antihypertensive medications among older Medicaid-insured individuals.
Retrospective study using linked 2006-2014 state of Missouri's Medicaid claims and Supplemental Nutrition Assistance Program data.
Older adults (≥ 60 years) who were continuously enrolled in Medicaid for 12 months following their first observed claim for hypertension at or after age 60.
The outcome measure was medication adherence assessed using the proportion of days covered (PDC). The exposure measures were as follows: (1) receipt of SNAP benefits (no [0], yes [1]); (2) SNAP benefits receipt during the 12-month Medicaid continuous enrollment (no [0], yes [1]); (3) duration of SNAP participation during the 12-month continuous Medicaid enrollment; and (4) SNAP participation pattern.
On multivariable analyses, there was a statistically significant association between ever participating in SNAP and medication adherence (β = 0.32; S.E. = 0.011). Compared to those who participated in SNAP for 1-3 months during the 12-month continuous enrollment, there was an increased likelihood of medication adherence among those who were enrolled for 10-12 months (β = 0.44, S.E. = 0.041).
Medicaid-insured older adults who are SNAP participants or enrolled in SNAP for 10-12 months of a 12-month Medicaid continuous enrollment period are more likely to be adherent to antihypertensive medication compared to non-SNAP participants or those enrolled for 1-3 months, respectively.
食物不安全与患有高血压等慢性病的个体的药物不依从有关。补充营养援助计划（SNAP）-一项解决食物不安全问题的公共计划-与医疗保险覆盖的老年高血压患者的药物依从性之间的关系尚不清楚。
分析 SNAP 参与模式与医疗保险覆盖的老年高血压患者抗高血压药物依从性之间的关联。
使用 2006-2014 年密苏里州医疗保险索赔和补充营养援助计划数据进行的回顾性研究。
连续 12 个月参加医疗保险的老年人（≥60 岁），在 60 岁后首次观察到高血压的情况下连续 12 个月内参加医疗保险。
使用覆盖天数比例（PDC）评估药物依从性。暴露措施如下：（1）获得 SNAP 福利（否[0]，是[1]）；（2）在 12 个月的医疗保险连续参保期间获得 SNAP 福利（否[0]，是[1]）；（3）在 12 个月的医疗保险连续参保期间 SNAP 参与的持续时间；和（4）SNAP 参与模式。
在多变量分析中，曾经参加过 SNAP 与药物依从性之间存在统计学显著关联（β=0.32；S.E. = 0.011）。与在 12 个月的连续参保期间参加 SNAP 1-3 个月的人相比，在 12 个月的医疗保险连续参保期间参加 SNAP 10-12 个月的人更有可能遵医嘱服用药物（β=0.44，S.E. = 0.041）。
与非 SNAP 参与者或分别参加 1-3 个月 SNAP 的参与者相比，参加 SNAP 或在医疗保险连续参保期间参加 SNAP 10-12 个月的医疗保险覆盖的老年成年人更有可能遵医嘱服用抗高血压药物。
