Fresh Food Farmacy
Trial question
What is the effect of intensive food-as-medicine program in patients with diabetes and food insecurity?
Study design
Multi-center
Open label
RCT
Population
Characteristics of study participants
54.0% female
46.0% male
N = 349
349 patients (187 female, 162 male).
Inclusion criteria: patients with diabetes and food insecurity.
Key exclusion criteria: on hospice or palliative care; acute or chronic psychosis; active medical disorder that would preclude participation in the classes, weekly clinic visits, or result in a limited diet.
Interventions
N=179 food-as-medicine intervention (10 healthy meals/week for the household plus diabetes education, dietician support, and health coaching for 1 year).
N=170 wait list control (usual care, information on local food banks, and an invitation to join intervention after 6 months).
Primary outcome
Hemoglobin A1c levels at 6 months
8.78%
8.81%
8.8 %
6.6 %
4.4 %
2.2 %
0.0 %
Food-as-medicine
intervention
Wait list
control
No significant
difference ↔
No significant difference in HbA1c levels at 6 months (8.78% vs. 8.81%; ARD -0.1, 95% CI -0.46 to 0.25).
Secondary outcomes
Significant increase in active prescription drug order for metformin (58.26% vs. 50.64%; AD 7.18%, 95% CI 0.71 to 13.64).
Significant increase in active prescription drug order for GLP-1 agonist (49.56% vs. 35.32%; AD 12.77%, 95% CI 6.47 to 20.07).
Significantly greater improvement in diet from 1 year ago (93.3% vs. 77.2%; AD 16.92%, 95% CI 9.22 to 24.61).
Conclusion
In patients with diabetes and food insecurity, food-as-medicine intervention was not superior to wait list control with respect to HbA1c levels at 6 months.
Reference
Joseph Doyle, Marcella Alsan, Nicholas Skelley et al. Effect of an Intensive Food-as-Medicine Program on Health and Health Care Use: A Randomized Clinical Trial. JAMA Intern Med. 2024 Feb 1;184(2):154-163.
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