Tip of the Week: Managing Care Delivery to the Homeless Population

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Addressing the health concerns of homelessness involves the creativity of all health care professionals in their respective roles.

The economic impact of the coronavirus disease 2019 (COVID-19) has left many people in the United States in a precarious living situation. Prior to the pandemic, homelessness was a pervasive occurrence throughout the country, and as the virus continues to rampage through our communities, the likelihood is that homelessness will only become further exacerbated in the interim and aftermath of the pandemic. Homelessness, as a social determinant of health, is a problem faced by hundreds of thousands to potentially millions of people across the country.1

Individuals who are homeless are more likely to suffer from poor health and have been found to have increased usage of the emergency department, creating an economic burden on health systems across the nation.2,3

Addressing the health concerns of homelessness involves the creativity of all health care professionals in their respective roles. It is in the interest of the pharmacy manager to deliver to the needs of our communities by creating value-added services that relieve pressure off our local health systems.

One of the recent innovative strategies was performed by a pharmacy resident who, under a collaborative practice agreement, performed cardiovascular risk reduction disease state management once a week at a clinic that serves homeless people.4 In the encounters, the pharmacist was able to perform services such as tobacco cessation, patient education, comprehensive medication reviews, and medication regimen optimization.4 During each interaction, the clinical pharmacist was able to perform an average of 4 interventions.

This study demonstrates the value that a clinical pharmacist can bring to a health care team. By being able to perform independent disease state management, a pharmacist gave members of a vulnerable population the opportunity to receive time and attention from a knowledgeable health care professional, showing the value that pharmacists bring to issues of public health.

The provision of value-added services not only allows pharmacists to practice at the top of their license and help patients in need, but it also enhances the image of pharmacists in the public eye. The encouraging results of this study demonstrate the extent to which pharmacists can be integrated into various health care teams to provide value for the public.

Pharmacy managers can facilitate the awareness of their staff of vulnerable populations and determine efficient and effective methods to leverage available resources in delivering care to these patients, even seeking them out so as to make for a healthier population.

Eric Flemings is a PharmD candidate at Touro University California College of Pharmacy.

Shane Desselle, RPh, PhD, FAPhA is a professor of social and behavioral pharmacy at Touro University California College of Pharmacy.

REFERENCES

  • Jackson MP, McSwane DZ. Homelessness as a Determinant of Health. Public Health Nursing 1992; doi: 10.1111/j.1525-1446.1992.tb00098.x
  • Stafford A, Wood L. Tackling Health Disparities for People Who are Homeless? Start with Social Determinants. Int J Environ Res Public Health 2017; doi: 10.3390/ijerph14121535
  • Kushel MB, Perry S, Bangsberg D, Clark R, Moss AR. Emergency department use among the homeless and marginally housed: results from a community-based study. Am J Public Health 2002; doi: 10.2105/ajph.92.5.778
  • Albertson S, Murray T, Triboletti J, Pence L et al. Implementation of primary care clinical pharmacy services for adults experiencing homelessness. J Am Pharm Assoc. 2020; doi: https://doi.org/10.1016/j.japh.2020.10.012