Clinical Pharmacy Intervention for Persons Experiencing Homelessness: Evaluation of Patient Perspectives in Service Design and Development

Abstract

Persons experiencing homelessness have a high prevalence of severe mental health problems, alcohol dependence, substance misuse and infectious hepatitis C, and face up to twelve times higher mortality rates compared to the general population. They also face barriers to accessing healthcare. However, clinical pharmacy services are currently not available to homeless populations in England. The aim of this study was to conduct public involvement sessions with persons experiencing homelessness with a view to inform the design of patient-centred clinical pharmacy healthcare services. Qualitative methodology was used, using a focus group with homeless persons from emergency shelters and one to one engagement with those sleeping rough, using a topic guide. A total of nine homeless persons took part—seven males and two females. The participants of the sessions said that patient-centred clinical pharmacy services delivered for homeless persons would address many of their unmet needs around access to medicines, their understanding of prescribed medicines and holistic management of their health. The service would be able to make a positive impact on their health outcomes by screening for health conditions, facilitating better integration across services, referral and liaison with other services, and minimising misuse of prescribed medicines. The findings of this study will be used to inform the development, implementation and evaluation of a patient-centred clinical pharmacy service tailored to meet the specific needs of the homeless population.

Representation of persons experiencing homelessness and coding of homelessness in general practices: descriptive evaluation using healthcare utilisation data

“… 25 , 26 Qualitative studies show that PEH value such dedicated services. 27 , 28 Establishment of tailored interventions, including outreach-based services, have been advocated in the NHS L ong T erm P lan . 29 There is also scope to widen the roles of community pharmacies as PEH utilise pharmacies on a regular basis for substance misuse treatment, needle exchange, and prescription collection.…”

Research priorities in healthcare of persons experiencing homelessness: outcomes of a national multi-disciplinary stakeholder discussion in the United Kingdom

“…Our study also did not involve PEH participation because this event mainly aimed to draw on the voice of the stakeholder groups involved in the care of PEH. However, the researchers drew their prior experiences of working with PEH when informing the discussion plans for this event [25][26][27][28]. Identifying priority areas of research in the future will require consensus and nominal group techniques [29] for participants to agree on the agenda and future priorities.…”

Barriers to monitoring and management of cardiovascular and metabolic health of patients prescribed antipsychotic drugs: a systematic review

“…Multi-morbidity including poor mental, physical health and substance misuse and poor access to services can lead to homelessness and social disparities [39][40][41][42]. There is a need to develop innovative services delivery models, such as outreach programmes to support patients with severe mental health [43][44][45] and evaluate their impact on health and quality-of-life outcomes.…”