Assessing health conditions and medication use among the homeless community in Long Beach, California

Abstract

Objective:Persons experiencing homelessness are a vulnerable population and are at increased risk for morbidity and all-cause mortality compared to the general population. This study sought to evaluate medication use, regular physician visits, and identify health conditions among the homeless population of Long Beach, California.Methods:Two “brown bag” medication review events were held at homeless shelters in the Long Beach area. Demographic information, medication use, and comorbid disease states were obtained through surveys.Findings:Three-fourths of the cohort (95 participants) consisted of males, and the average age of participants was 48 years. Psychiatric disorders and cardiovascular disease were the most common disease states reported at 32% and 46%, respectively and so were medications used in treating these chronic diseases. Medication adherence was found to be a significant problem in this population, where more than 30% of patients were nonadherent to medications for chronic diseases. Furthermore, foot problems, hearing and vision difficulties constitute the most commonly overlooked health problems within the homeless population.Conclusion:Based on this and other similar finding, we must accept that the homeless represent a vulnerable population, and that because of this fact, more programs should be focused at improving availability and access to health care among the homeless. Regarding the high number of reported health problems in the study, more studies are needed and more studies should incorporate screening for foot, hearing, and vision issues, both to increase awareness and to provide an opportunity for devising possible solutions to these highly preventable conditions.

Foot Conditions among Homeless Persons: A Systematic Review

“…Twelve studies included in the review were conducted in the United States, [9]-[20] two in the United Kingdom, [21], [22] two in France, [23], [24] and one in Italy. [25] The majority of studies included homeless shelter residents or patients who attended clinics dedicated to serving vulnerable populations.…”

“…Seven (50%) studies included patients from clinics that served homeless individuals, [9], [10], [13]-[15], [21], [22] while eight (47%) studies recruited participants directly from homeless shelters. [11], [12], [16], [17], [19], [20], [23], [24] One study recruited homeless individuals from a volunteer health service outreach association, [25] and another study recruited homeless individuals from a community kitchen. [18] Ten (59%) studies included participants from more than one location (e.g.…”

“…[20] One longitudinal, non-interventional study found that homeless participants’ podiatric concerns significantly decreased over time from 12.4% at baseline to 5.7% at 18 months. [17]…”

Health status and health behaviour of the Hungarian homeless people

“…The prevalence of smoking, alcohol and drug addiction is higher in the homeless population than in the general population (12)(13)(14)(15)(16). Material deprivation also limits their ability to purchase and take medications and to manage health issues that otherwise are relatively easy to control (17).…”

Housing First Improves Adherence to Antipsychotic Medication Among Formerly Homeless Adults With Schizophrenia: Results of a Randomized Controlled Trial

“…Poor adherence to antipsychotic medication is a significant problem among homeless people, 5 , 6 leading to increased risk of relapse, hospitalization and suicide, 7 arrest, violence and victimization, 8 and greater overall public costs. 9 Duration of homelessness is significantly associated with suboptimal adherence to prescribed antipsychotic regimens.…”