Food as Medicine Clinic: Early Results and Lessons Learned

Abstract

Introduction: Hospital-based food pantries are commonly used to address food insecurity. However, few studies have examined the impact of these food pantries on patients with chronic health conditions. In this study, we sought to assess the effect of a hospital-based food pantry clinic on self-reported dietary changes, health outcomes, and resource utilization.Methods: This study included food insecure participants with suboptimally controlled congestive heart failure, hypertension, or diabetes who visited a Food as Medicine (FAM) clinic at an academic healthcare system between October 2018 and November 2019. The clinic provided a three-day supply of food for participants and their families up to two times per month for up to 12 months. Baseline, three-month, and six-month surveys were used to assess dietary behaviors, and electronic health record (EHR) data were used to assess health outcomes and utilization. Multivariable Poisson regression was used to explore variables associated with FAM clinic use.Results: At three months, participants self-reported improved dietary behaviors, including increased consumption of fruits and vegetables as snacks and an increased variety of fruits and vegetables consumed. There were no statistically significant changes in clinical or healthcare utilization measures, despite small absolute improvements in systolic blood pressure (SBP), hospitalizations, and emergency department (ED) visits. There was a weak association between FAM clinic visit frequency and changes in dietary behaviors.Conclusion: Among patients with chronic diseases, the use of the FAM clinic was associated with improved self-reported dietary behaviors and a nonsignificant improvement in health outcomes and resource utilization.

Food Is Medicine: A Presidential Advisory From the American Heart Association

“…Medically tailored groceries (or nontailored groceries) can provide many different food groups (eg, vegetables, fruits, beans, grains, lean proteins, dairy 72 ; Figure 3). Grocery provision may involve food banks, 63,73,74 food pantries, [56][57][58]75,76 or food pharmacies ("farmacies"), 77,78 often affiliated with a health care or clinical facility. 56,57,75,79 As with healthy food prescriptions, the impact of both medically tailored groceries and nontailored groceries interventions can be limited by low engagement and incomplete redemption of benefits, with a number of studies finding voucher redemption rates in the range of 35% to 40%.…”

“…Grocery provision may involve food banks, 63,73,74 food pantries, [56][57][58]75,76 or food pharmacies ("farmacies"), 77,78 often affiliated with a health care or clinical facility. 56,57,75,79 As with healthy food prescriptions, the impact of both medically tailored groceries and nontailored groceries interventions can be limited by low engagement and incomplete redemption of benefits, with a number of studies finding voucher redemption rates in the range of 35% to 40%. 57,58,63,73 Some studies have examined clinical outcomes, 63,74,[76][77][78][79][80] but others emphasized operational and implementation factors such as engagement or program participation [56][57][58]81 or diet quality or food security.…”

“…73,75,77,82 Among the studies examining clinical measures, the most common outcome was hemoglobin A1c, 63,74,76,[78][79][80] with a few studies also measuring weight, body mass index, or blood pressure. Only one of the studies identified was a randomized controlled trial 63 ; many had pre-post designs 58,73,[75][76][77][78]80,82 ; and the others were a mixture of quasi-experimental, pilot, or chart review studies. Only a few of the studies assessing hemoglobin A1c or clinical measures reported statistically significant improvements, and those that did often found this to be true for only a small subset of study participants who were most engaged in the programs or had the most room for improvement.…”

“…57,58,63,73 Some studies have examined clinical outcomes, 63,74,[76][77][78][79][80] but others emphasized operational and implementation factors such as engagement or program participation [56][57][58]81 or diet quality or food security. 73,75,77,82 Among the studies examining clinical measures, the most common outcome was hemoglobin A1c, 63,74,76,[78][79][80] with a few studies also measuring weight, body mass index, or blood pressure. Only one of the studies identified was a randomized controlled trial 63 ; many had pre-post designs 58,73,[75][76][77][78]80,82 ; and the others were a mixture of quasi-experimental, pilot, or chart review studies.…”

The Role of Agricultural Systems in Teaching Kitchens: An Integrative Review and Thoughts for the Future

“…Another PPP was implemented at an academic healthcare system through a Food as Medicine clinic, wherein food-insecure participants received an allotted amount of food for up to one year. While short-term health outcomes did not improve significantly, self-reported dietary behaviors did, suggesting some degree of efficacy of the program, with helpful directives for future research, such as larger sample sizes, longer term studies, and tracking of additional health metrics [ 47 ].…”