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Community pharmacy

Two-thirds of homeless patients prescribed medicine in pharmacy-led outreach service

Medicines have been prescribed to almost two-thirds (62%) of patients treated by a pharmacist-led homeless health outreach service in Glasgow, according to a report published in the International Journal of Pharmacy Practice.

The Homeless Health Assertive Outreach Service, developed by pharmacist independent prescribers allied to a homeless health GP surgery team in Glasgow, established pop-up clinics in venues including soup kitchens, hostels and day centres across the city centre.

Of 52 patients seen between 1 March 2017 and 1 December 2017, 32 patients (62%) were prescribed medicine, 22 patients were initiated on a new medicine, and 21 patients were given a repeat prescription or were restarted on medicine they had previously taken.

New clinical issues were identified in more than two-thirds (69%) of patients, with infectious conditions, such as dental infections and skin rashes, being the most common conditions identified. Four patients were newly diagnosed with asthma, while four patients were found to be diabetic or prediabetic. One case of opioid overdose and one pregnancy were also diagnosed by the team’s pharmacists.

Most (62%) patients had their presenting issues managed solely by the pharmacist, although referrals to other healthcare professionals, and to social care services, were made, including to dentists, addiction teams and mental health care services. A large majority (85%) of the patients seen returned for follow-up care from the pharmacist, or from the service that they had been referred to.

Six of the patients were sleeping rough; the remainder were in hostels, ‘sofa-surfing’ or in other forms of insecure accommodation. The pharmacist-led engagement with these patients is, the report’s authors said, the first service of its kind and demonstrated “good levels of patient engagement … with regard to the pharmacist and onward referrals”.

The authors note that this study did not measure medicines adherence, and they add that more work is needed to find out whether these interventions reduce the need for emergency care and lead to an increased use of primary care services among the homeless population.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2019.20206294

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