W3 – Health inequalities in vulnerable patient groups – homelessness

Link to EAHP Statements
Section 4 – Clinical Pharmacy: Statements – 4.1, 4.5, 4.6, 4.8
Section 5 – Patient Safety and Quality Assurance: Statements – 5.9
Section 6 – Education and Research: Statement Statements – 6.2

Abstract

Homelessness is increasing across Europe. It is an intolerable injustice, associated with an increased risk of premature death from preventable causes. These include premature multimorbidity, under-diagnosis, under-treatment and high rates of non-adherence with medicines for primary and secondary prevention of common health conditions. Rather than being a lifestyle choice, poly-substance dependency with street drugs develops as a result of people experiencing homelessness (PExH) self-medicating to block previous or ongoing adverse and traumatic experiences. Across Europe, PExH have higher health and social care costs than the domiciled population, attributable to high costs charged by owners of temporary accommodation, higher rates of emergency department attendance, ambulance call-outs, hospital admissions and criminal justice encounters. The timing is propitious for Pharmacy professionals across Europe to do more to improve the long-term care and processes of care for PExH.

Learning objectives
After the session, the participant should be able to:
– Understand the unique, multifaceted and unmet needs of PExH in the community and in hospital.
– Describe the importance of pragmatic randomised controlled trials and qualitative process evaluations, as a means of evidencing the impact of pharmacy professionals and third sector homelessness charity workers, for people with COPD and PExH.
– Join a multiagency research team set in seven countries across Europe, to plan and conduct a game changing definitive randomised controlled trial aiming to reduce unscheduled care use, through addressing underdiagnosis and undertreatment of PExH with COPD.

Educational need addressed
This session will address any lack of understanding of the health and wider needs of people experiencing homelessness, the merits of evidence from rigorous quantitative and qualitative research, update participants on best practice in terms of hospital discharge schemes for this vulnerable group and cover some common areas of therapeutics worth attention and intervention.

Keywords
Homelessness, health inequalities, multimorbidity, health services research, courtesy and humanity.