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 homeless -
ness 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 pre -
scribing 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-man-
aged. Wide variations in data across practices needs investigation.
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 homeless -
ness 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 pre -
scribing 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-man-
aged. Wide variations in data across practices needs investigation.
| Original language | English |
|---|---|
| Pages (from-to) | 717-724 |
| Number of pages | 8 |
| Journal | International Journal of Clinical Pharmacy |
| Volume | 44 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - 23 May 2022 |
Bibliographical note
Funding Information:None.
Publisher Copyright:
© 2022, The Author(s).
Keywords
- Homelessness
- prescribing
- inequality