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

<jats:p>&lt;p dir="ltr"&gt;Objective&lt;/p&gt;&lt;p dir="ltr"&gt;To assess the prevalence of housing instability and its associations with cost-related nonadherence and financial toxicity among adults with uncontrolled diabetes.&lt;/p&gt;&lt;p dir="ltr"&gt;Research Design and Methods&lt;/p&gt;&lt;p dir="ltr"&gt;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.&lt;/p&gt;&lt;p dir="ltr"&gt;Results&lt;/p&gt;&lt;p dir="ltr"&gt;Half (n=298) reported housing instability, which was associated with greater odds of cost-related nonadherence (aOR=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.&lt;/p&gt;&lt;p dir="ltr"&gt;Conclusions&lt;/p&gt;&lt;p dir="ltr"&gt;Housing instability was associated with financial toxicity and, in primary models, with cost-related nonadherence. Findings should be validated in longitudinal, nationally representative samples.&lt;/p&gt;&lt;p&gt;&lt;br&gt;&lt;/p&gt;</jats:p>