November 20, 2019

Food insecurity and prescription drug non-adherence correlate, according to a recent study by Canadian and U.S. researchers.

The study may go some way to explaining the negative health outcomes experienced by food-insecure Canadians.

The study, by researchers from the universities of Toronto, Illinois and Manitoba, was published Sept. 23 in CMAJ Open, an online journal run by a subsidiary of the Canadian Medical Association using an open peer review model.

Study coauthor Fei Men said in a phone interview, “The key message of the study is that food insecurity, in particular the moderate and severe food insecurity, were significantly associated with cost-related medication non-adherence among the adult respondents that we sampled.” Men is a postdoctoral fellow at the University of Toronto.

Prescription drug non-adherence is when a patient in some way doesn’t take prescribed medication as much as he or she should, or at all.

Of the study’s sample of 11,172 Canadians, 8.3 per cent said they didn’t adhere to their prescriptions because of cost, of whom about 48 per cent were from food-insecure households.

“Compared to adherents, non-adherents were more likely to be female, young, renters, of Aboriginal identity and from lower-income households, and to report no drug insurance,” the study states.

The study data came from Statistics Canada’s 2016 Community Health Survey. The researchers didn’t use data from Ontario, Newfoundland and Labrador or the territories because one or both of the relevant modules weren’t administered there. But Men said the picture in Ontario would likely be similar.

Having drug insurance was associated with a lower rate of non-adherence, but didn’t eliminate the trend.

“Having insurance is not the same as having no co-payment or other out-of-pocket expense,” said Men. “So as long as there is an out-of-pocket expense, which is true in most cases, then those who have limited financial resources are likely to experience trouble paying for those costs.”

Those with moderate food insecurity felt their health was worse, and those with severe food insecurity also used health services more.

Men observed, “It doesn’t make sense to force people into hospital or to go to the emergency department when you can solve the issue with supplying them with regular medication, which is way cheaper. So what we think is appropriate is to either lower or exempt the out-of-pocket expenses of drug prescriptions for those with limited resources.”

However, the study authors were careful to note statistical correlation doesn’t necessarily indicate causation.

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