Is SNAP the Solution to Healthcare’s Medication Adherence Woes?

February 27, 2024 - Connecting patients experiencing food insecurity with SNAP benefits could improve medication adherence by as much as nearly 14 percent, according to new data from The Ohio State University.

The study, spearheaded by researchers from the University’s Schools of Pharmacy and Medicine, showed that SNAP’s impact is primarily salient among a food-insecure population.

Food insecurity has come under the healthcare industry’s microscope as more experts consider the social determinants of health that affect outcomes. Food insecurity can impact multiple aspects of everyday life, including the tolerability of medicines and outcomes for diet-related illnesses like diabetes or heart disease.

“Food insecurity impairs medication adherence because patients are confronted with a challenging situation in which they must either feed themselves or spend limited resources on antihypertensive medications,” the researchers explained in the study’s introduction. “Often, it is patients of limited financial means who must make this difficult choice.”

SNAP—the Supplemental Nutrition Assistance Program—is a key public benefit that many healthcare policymakers have indicated could be essential to addressing hunger as an SDOH. Previous studies have shown that SNAP can cut poverty by as much as 16 percent and reduce food insecurity by as much as 30 percent, the researchers said.

This latest study, which focused on patient medication adherence for hypertension, also indicated that SNAP could enable better patient engagement.

In a retrospective cohort study from between 2016 and 2017, the researchers looked at how SNAP enrollment affected self-reported medication nonadherence in the Medical Expenditure Panel Survey (MEPS)–National Health Interview Survey (NHIS).

While SNAP enrollment had a limited overall effect on medication nonadherence, the program did help patients who reported experiencing food insecurity.

The food-insecure study population saw a 13.4 percent decrease in medication nonadherence, while the food-secure population saw little impact from SNAP.

These findings echo similar studies done in the past, the researchers said. In particular, the data indicates that SNAP helps head off any cost-related medication adherence barriers patients might experience (in other words, make medication more affordable by stemming other high cost-of-living expenses).

That’s a big deal, considering the role cost plays in reducing patient access to medication. In a May 2023 JAMA Network Open study, researchers reported that cost-related medication adherence barriers affect around one in five patients.

The study from The Ohio State indicates SNAP as a policy solution, but the nation’s policy climate might stand in the way.

“Given the recent rollbacks in SNAP assistance, more individuals and families are likely to experience food insecurity and may be less likely to refill medications to treat chronic disease,” the researchers noted.

“The results of our sensitivity analysis suggested that SNAP may be associated with higher adherence for even the overall antihypertensive user population that was included,” they pointed out. “Therefore, these findings suggest that policy makers should expand SNAP access among patients with hypertension to prevent nonadherence to antihypertensive medications.”

There is more that healthcare providers might be able to do, too, the research team indicated. Referrals to food assistance programs, for example, could make a difference.

Still, the study authors noted that ensuring access to SNAP benefits could move the needle on medication adherence beyond the measures included in their analysis.

“Our findings also suggest that SNAP participation may potentially increase medication adherence in general and not just cost-related nonadherence, considering that we controlled for health insurance status and out-of-pocket spending as suggested by previous studies,” they concluded. “If our findings are confirmed by other studies, especially through interventional or quasi-experimental designs, it is possible that the benefits of SNAP may well go beyond addressing cost-related barriers.”