Health Status, Health Care Use, Medication Use, and Medication Adherence Among Homeless and Housed People Living With HIV/AIDS

Kidder, Daniel P.; Wolitski, Richard J.; Campsmith, Michael; Nakamura, Glenn V.

doi:10.2105/ajph.2006.090209

Cited by 181 publications

(148 citation statements)

References 49 publications

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“…Contrasting with previous investigations that reported numerous barriers to the use of healthcare services by the homeless 23,24,25 , in our study no meaningful differences were found between the homeless sample and general population sample regarding recent measurement of blood pressure and blood analysis. This could be explained by the fact that the Portuguese Constitution establishes that all citizens are entitled to health protection and access to healthcare provided by the National Health Service 27 .…”

Section: Discussioncontrasting

confidence: 99%

“…Several studies reported prevalence of hypertension among the homeless ranging from 14% to 51% 14,15,17,18,19,20,21 , and prevalence of tobacco and alcohol consumption of almost 80% and 30% respectively 12,14,22 . Furthermore, the fact that the homeless population experiences difficulties in obtaining and maintaining stable sources of medical care has also been described as a barrier to appropri-ARTIGO ARTICLE ate healthcare 23,24,25 that contributes to a lack of awareness of these health problems and difficulties in adhering to treatment regimens 26 . In Portugal, however, these factors are expected to have a lower impact on the health status of the homeless population because healthcare assistance is provided by the National Health Service which is universal, comprehensive and free of charge for individuals that do not have the financial means to support the relatively low fees 27 .…”

Section: Introductionmentioning

confidence: 99%

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Risk factors for cardiovascular disease among the homeless and in the general population of the city of Porto, Portugal

et al. 2012

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We described the distribution of risk factors for cardiovascular disease among homeless people living in the city of Porto, Portugal. Comparisons were made between subsamples of homeless people recruited in different settings and between the overall homeless sample group and a sample of the general population. All "houseless" individuals attending one of two homeless hostels or two institutions providing meal programs on specific days were invited to participate and were matched with subjects from the general population. We estimated sex, age and education-adjusted prevalence ratios or mean differences. The prevalence of previous illicit drug consumption and imprisonment was almost twice as high among the homeless from institutions providing meal programs. This group also showed lower mean systolic and diastolic blood pressure. Prevalence of smoking was almost 50% higher in the overall homeless group. Mean body mass index and waist circumference were also lower in the homeless group and its members were almost five times less likely to report dyslipidemia. Our findings contribute to defining priorities for interventions directed at this segment of society and to reducing inequalities in this extremely underprivileged population.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Risk factors for cardiovascular disease among the homeless and in the general population of the city of Porto, Portugal

et al. 2012

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“…The geographic disparities mentioned above overlap with underlying socioeconomic and racial inequalities driving the US epidemic: for example, poorer communities have higher rates of HIV/AIDS and patients with low socioeconomic status have lower survival rates; [35][36][37][38] patients without adequate insurance are less likely to be on antiretroviral therapy; 39 substance users and minorities are more likely to delay 43 To complement clinician-based changes such as those suggested previously, primary care networks can help improve access to HIV treatment and reduce important health disparities by implementing systemsbased strategies (e.g., community-based HIV service programs) to provide appropriate care. These programs may be especially valuable for patients who cannot easily travel to specialty centers as well as vulnerable and medically underserved groups.…”

Section: Hiv-related Health Disparitiesmentioning

confidence: 99%

An Epidemic in Evolution: The Need for New Models of HIV Care in the Chronic Disease Era

2011

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Since the beginning of the AIDS epidemic, models of HIV care have needed to be invented or modified as the needs of patients and communities evolved. Early in the epidemic, primary care and palliative care predominated; subsequently, the emergence of effective therapy for HIV infection led to further specialization and a focus on increasingly complex antiretroviral therapy as the cornerstone of effective HIV care. Over the past decade, factors including (1) an aging, long-surviving population; (2) multiple co-morbidities; (3) polypharmacy; and (4) the need for chronic disease management have led to a need for further evolution of HIV care models. Moreover, geographic diffusion; persistent disparities in timely HIV diagnosis, treatment access, and outcomes; and the aging of the HIV provider workforce also suggest the importance of reincorporating primary care providers into the spectrum of HIV care in the current era. Although some HIV-dedicated treatment centers offer comprehensive medical services, other models of HIV care potentially exist and should be developed and evaluated. In particular, primary care-and community-based collaborative practices-where HIV experts or specialists are incorporated into existing health centers-are one approach that combines the benefits of HIV-specific expertise and comprehensive primary care using an integrated, patient-centered approach.

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“…While the patient population served lacks insurance and can often not afford any additional out-ofpocket costs, there are still additional barriers and factors involved in their adherence. 7,8 Previous work has shown that patients who experience homelessness also commonly experience frequent transitions of care and change in providers in the health care system, as well as transitions throughout social and legal services. With these factors, these patients are highly susceptible to medication errors, gaps in medication use, and inconsistent access.…”

Section: Gaining Patient Buy-inmentioning

confidence: 99%

Development and Implementation of Charitable Pharmacy Services within a Federally-Qualified Health Center (FQHC)

Mospan¹,

Alexander²

2015

Innov Pharm

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Underserved patient populations often have limited access to health care services, especially medications, leading to lower quality care due to their transitional status and lack of access. To ensure access to medications for underserved patients in the Johnson City, Tennessee area, the Colleges of Nursing and Pharmacy at ETSU developed a charitable pharmacy to serve those of greatest need in hopes of improving quality of care. By establishing a community pharmacy within a FQHC, clinical community pharmacists were able to establish enhanced community pharmacy services as a part of the health-care team. This manuscript describes the development, implementation, and benefits of the community pharmacy integration within a FQHC Type: Clinical Experience

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Health Status, Health Care Use, Medication Use, and Medication Adherence Among Homeless and Housed People Living With HIV/AIDS

Abstract: Homeless people with HIV/AIDS are at increased risk of negative health outcomes, and housing is a potentially important mechanism for improving the health of this vulnerable group.

Cited by 181 publications

References 49 publications

Risk factors for cardiovascular disease among the homeless and in the general population of the city of Porto, Portugal

Risk factors for cardiovascular disease among the homeless and in the general population of the city of Porto, Portugal

An Epidemic in Evolution: The Need for New Models of HIV Care in the Chronic Disease Era

Development and Implementation of Charitable Pharmacy Services within a Federally-Qualified Health Center (FQHC)

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