Housing Instability Associated With Cost-Related Nonadherence and Financial Toxicity in People With Uncontrolled Diabetes

IF 22.6 1区医学 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes Care Pub Date : 2026-08-13 DOI:10.2337/dc26-1152

Victoria H. Davis, Roshanak Mehdipanah, Minal R. Patel

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Abstract

OBJECTIVE To assess the prevalence of housing instability and its associations with cost-related nonadherence and financial toxicity among adults with uncontrolled diabetes. RESEARCH DESIGN AND METHODS We analyzed baseline randomized controlled trial data from 600 adults with uncontrolled diabetes and cost-related barriers to care. Logistic and linear regression assessed associations of housing instability with cost-related nonadherence and financial toxicity. RESULTS Half (n = 298) reported housing instability, which was associated with greater odds of cost-related nonadherence (adjusted odds ratio 1.64; 95% CI 1.05, 2.56) and worse financial toxicity (B = −4.64; 95% CI −6.20, −3.09). Cost-related nonadherence was not significant after adjusting for diabetes distress and symptoms of depression and anxiety; financial toxicity remained significant. In sensitivity analyses, worry about housing costs, not housing or utility needs, was associated with financial toxicity. CONCLUSIONS Housing instability was associated with financial toxicity and, in primary models, with cost-related nonadherence. Findings should be validated in longitudinal, nationally representative samples.

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未控制糖尿病患者的住房不稳定与费用相关的不依从和财务毒性相关

目的评估未控制的糖尿病成人中住房不稳定的患病率及其与成本相关的不依从性和财务毒性的关系。研究设计和方法我们分析了600名未控制的糖尿病成人和与费用相关的护理障碍的基线随机对照试验数据。Logistic和线性回归评估了住房不稳定性与成本相关的不遵守和财务毒性的关系。结果：一半（n = 298）报告了住房不稳定，这与成本相关的不依从率较高（调整优势比1.64;95% CI 1.05, 2.56）和更严重的财务毒性（B = - 4.64; 95% CI - 6.20, - 3.09）相关。在调整糖尿病困扰、抑郁和焦虑症状后，费用相关的不依从性不显著；金融毒性仍然很大。在敏感性分析中，对住房成本的担忧，而不是对住房或公用事业需求的担忧，与金融毒性有关。结论：住房不稳定与财务毒性有关，在初级模型中，与成本相关的不依从性有关。研究结果应在纵向的、具有全国代表性的样本中得到验证。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes Care 医学-内分泌学与代谢

CiteScore

27.80

自引率

4.90%

发文量

449

审稿时长

1 months

期刊介绍： The journal's overarching mission can be captured by the simple word "Care," reflecting its commitment to enhancing patient well-being. Diabetes Care aims to support better patient care by addressing the comprehensive needs of healthcare professionals dedicated to managing diabetes. Diabetes Care serves as a valuable resource for healthcare practitioners, aiming to advance knowledge, foster research, and improve diabetes management. The journal publishes original research across various categories, including Clinical Care, Education, Nutrition, Psychosocial Research, Epidemiology, Health Services Research, Emerging Treatments and Technologies, Pathophysiology, Complications, and Cardiovascular and Metabolic Risk. Additionally, Diabetes Care features ADA statements, consensus reports, review articles, letters to the editor, and health/medical news, appealing to a diverse audience of physicians, researchers, psychologists, educators, and other healthcare professionals.