title: Continuous access to medication and health outcomes in uninsured adults with type 2 diabetes.
abstract: OBJECTIVE
  Achievement of recommended targets for HbA1c, low-density lipoproteins (LDLs), and blood pressure (BP) improves outcomes in adults with diabetes. To meet targets, access to an affordable and consistent supply of medication is necessary, which can be challenging for the medically underserved. The Social Determinants of Health (SDOH) framework guided variable selection in this study, which explored the relationship between continuous access to medication and HbA1c, LDL, and BP in adults with type 2 diabetes who are uninsured and of low socioeconomic status.
  
  
  METHODS
  This study was conducted using archived medical record data and a convenience sample of adults (n = 65) who received health care on a mobile health van and medications from a pharmaceutical procurement program. Pre-post data were analyzed using dependent t-tests.
  
  
  CONCLUSIONS
  Continuous access to medication was related to improved HbA1c (p = .003), LDL (p = .004), and systolic BP (p = .025). Access to a consistent source of medications for chronic disease is related to improved health outcomes.
  
  
  CONCLUSIONS
  Knowledge was gained about the effect of improved access, nontraditional healthcare delivery systems, and improved outcomes related to collaboration among community partners. Interventions aimed at the wider SDOH may reduce disparities of the medically underserved.
authors.affiliation: College of Health and Human Services, School of Nursing, George Mason University, Fairfax, Virginia.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Toulouse
authors.affiliation: College of Health and Human Services, School of Nursing, George Mason University, Fairfax, Virginia.
authors.forename: Marie
authors.initials: M
authors.lastname: Kodadek
mesh_terms: D000328:Adult; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005260:Female; D006297:Health Services Accessibility / Q000592:standards*; D006801:Humans; D008297:Male; D017057:Medically Uninsured; D008875:Middle Aged; D017063:Outcome Assessment, Health Care
keywords: Diabetes type 2; medications, nurse-managed clinics; nurse practitioners; underserved; uninsured; vulnerable