title: Food insecurity and medication adherence in low-income older Medicare beneficiaries with type 2 diabetes.
abstract: Little is known about diabetes management among low-income older Americans. This study used statewide self-administered survey and Medicare claims data to examine the relationships of food insecurity and medication (re)fill adherence in a sample of Medicare Part D beneficiaries with type 2 diabetes in need of food assistance in Georgia in 2008 (n = 243, mean age 74.2 ± 7.8 years, 27.2% African American, 77.4% female). (Re)fill adherence to oral hypoglycemics was measured as Proportion of Days Covered. Food insecurity was assessed using a six-item validated standard measure. About 54% of the sample were food insecure. About 28% of the diabetic sample did not (re)fill any diabetes medication and over 80% had at least one diabetes complication. Food insecure participants showed comparable (re)fill adherence to food secure participants. However, 57% of food insecure participants were nonadherent to oral hypoglycemics. Underlying basic needs must be addressed to improve diabetes management in this population.
authors.affiliation: a Department of Foods and Nutrition , University of Georgia , Athens , Georgia , USA.
authors.forename: Elisabeth Lilian Pia
authors.initials: EL
authors.lastname: Sattler
authors.forename: Jung Sun
authors.initials: JS
authors.lastname: Lee
authors.forename: Vibha
authors.initials: V
authors.lastname: Bhargava
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D003131:Combined Modality Therapy / Q000191:economics / Q000523:psychology; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000453:epidemiology / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy* / Q000191:economics; D003927:Diet, Diabetic / Q000191:economics / Q000523:psychology; D005260:Female; D005523:Food Supply / Q000191:economics; D005845:Georgia / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D008137:Longitudinal Studies; D008297:Male; D054524:Medicare Part D; D055118:Medication Adherence / Q000523:psychology; D011203:Poverty; D015995:Prevalence; D014481:United States
chemical_list: D007004:Hypoglycemic Agents
keywords: food insecurity; medicare claims; medication (re)fill adherence; older adults; poverty; type 2 diabetes