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Medicines prescribing for homeless persons : analysis of prescription data from specialist homelessness general practices
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Khan, Aleena, Kurmi, Om P., Lowrie, Richard, Khanal, Saval and Paudyal, Vibhu (2022) Medicines prescribing for homeless persons : analysis of prescription data from specialist homelessness general practices. International Journal of Clinical Pharmacy, 44 (3). pp. 717-724. doi:10.1007/s11096-022-01399-3 ISSN 2210-7703.
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WRAP-Medicines-prescribing-for-homeless-persons-analysis-of-prescription-data-from-specialist-homelessness-general-practices-Khanal-22.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons Attribution 4.0. Download (830Kb) | Preview |
Official URL: http://dx.doi.org/10.1007/s11096-022-01399-3
Abstract
Background
Specialist homelessness practices remain the main primary care access point for many persons experiencing homelessness. Prescribing practices are poorly understood in this population.
Objective
This study aims to investigate prescribing of medicines to homeless persons who present to specialist homelessness primary care practices and compares the data with the general population.
Setting
Analyses of publicly available prescribing and demographics data pertaining to primary care in England.
Methods
Prescribing data from 15 specialist homelessness practices in England were extracted for the period 04/2019-03/2020 and compared with data from (a) general populations, (b) the most deprived populations, and (c) the least deprived populations in England.
Main outcome measure
Prescribing rates, measured as the number of items/1000 population in key disease areas.
Results
Data corresponding to 20,572 homeless persons was included. Marked disparity were observed in regards to prescribing rates of drugs for Central Nervous System disorders. For example, prescribing rates were 83-fold (mean (SD) 1296.7(1447.6) vs. 15.7(9.2) p = 0.033) items), and 12-fold (p = 0.018) higher amongst homeless populations for opioid dependence and psychosis disorders respectively compared to the general populations. Differences with populations in the least deprived populations were even higher. Prescribing medicines for other long-term conditions other than mental health and substance misuse was lower in the homeless than in the general population.
Conclusions
Most of the prescribing activities in the homeless population relate to mental health conditions and substance misuse. It is possible that other long-term conditions that overlap with homelessness are under-diagnosed and under-managed. Wide variations in data across practices needs investigation.
Impact of findings on practice statements
The majority of prescribing activities focused on homeless populations relates to mental health conditions and substance misuse.
Our findings suggest potential under-diagnoses and under-treatment of other long-term health conditions such as cardiovascular and respiratory conditions in homeless populations.
Improving access to prevention and treatment of wider long term health conditions that overlap with homelessness and promoting medicines optimisation and adherence to prescribed treatments are key to improving the health of homeless populations.
Item Type: | Journal Article | ||||||||||
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Subjects: | R Medicine > RM Therapeutics. Pharmacology | ||||||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Library of Congress Subject Headings (LCSH): | Homelessness , Homeless persons -- Health and hygiene, Drugs -- Prescribing , Homelessness -- Health aspects, Homeless persons -- Medical care | ||||||||||
Journal or Publication Title: | International Journal of Clinical Pharmacy | ||||||||||
Publisher: | Springer | ||||||||||
ISSN: | 2210-7703 | ||||||||||
Official Date: | June 2022 | ||||||||||
Dates: |
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Volume: | 44 | ||||||||||
Number: | 3 | ||||||||||
Page Range: | pp. 717-724 | ||||||||||
DOI: | 10.1007/s11096-022-01399-3 | ||||||||||
Status: | Peer Reviewed | ||||||||||
Publication Status: | Published | ||||||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||||||
Date of first compliant deposit: | 13 July 2022 | ||||||||||
Date of first compliant Open Access: | 13 July 2022 |
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