Supplemental Nutrition Assistance Program Participation and Medication Adherence Among Medicaid-Insured Older Adults Living with Hypertension

Background: 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. Objective: To analyze the association between patterns of SNAP participation and adherence to antihypertensive medications among older Medicaid-insured individuals. Design: Retrospective study using linked 2006–2014 state of Missouri’s Medicaid claims and Supplemental Nutrition Assistance Program data. Participants: 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. Main Measures: 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. Key Results: 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). Conclusions: 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.