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01.07.2020 | Original Paper

Medical Comorbidities and Medication Use Among Homeless Adults Seeking Mental Health Treatment

verfasst von: Elizabeth Mayfield Arnold, Chance R. Strenth, Luke P. Hedrick, Robert C. Paterson, Julian Curiel, Amira E. Joseph, Thomas W. Brown, James N. Kimball

Erschienen in: Community Mental Health Journal | Ausgabe 5/2020

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Abstract

Little is known about the medical conditions and medication use of individuals who are homeless and have mental health problems. This study used secondary data (N = 933) from a mental health clinic serving homeless adults. Primary outcomes were the number and types of self-reported medical conditions and medications. About half (52.60%) of participants were taking one or more medications (mean = 1.67; SD = 2.30), most commonly antidepressants, antipsychotics, and anticonvulsants. Most frequently reported medical conditions were headaches/migraines, hypertension, and arthritis with a mean of 3.09 (SD = 2.74) conditions. Age and sex were significant predictors of the number of medical conditions. Age and the length of time homeless were significant predictors of the number of medications taken. Results suggest that those who are older and have been homeless longer appear to be increased risk for health problems and may need more medications to manage these conditions.

Allen, D. M., Lehman, J. S., Green, T. A., Lindegren, M. L., Onorato, I. M., & Forrester, W. (1994). HIV infection among homeless adults and runaway youth, United States, 1989–1992 Field Services Branch. AIDS,8(11), 1593–1598.CrossRef

Asgary, R., Sckell, B., Alcabes, A., Naderi, R., Schoenthaler, A., & Ogedegbe, G. (2016). Rates and predictors of uncontrolled hypertension among hypertensive homeless adults using New York City shelter-based clinics. Annals of Family Medicine,14(1), 41–46. https://doi.org/10.1370/afm.1882.CrossRefPubMedPubMedCentral

Babidge, N. C., Buhrich, N., & Butler, T. (2001). Mortality among homeless people with schizophrenia in Sydney, Australia: A 10-year follow-up. Acta Psychiatrica Scandinavia,103(2), 105–110.CrossRef

Baggett, T. P., Liauw, S. S., & Hwang, S. W. (2018). Cardiovascular disease and homelessness. Journal of the American College of Cardiology,71(22), 2585–2597. https://doi.org/10.1016/j.jacc.2018.02.077.CrossRefPubMed

Baggett, T. P., O'Connell, J. J., Singer, D. E., & Rigotti, N. A. (2010). The unmet health care needs of homeless adults: A national study. American Journal of Public Health,100(7), 1326–1333. https://doi.org/10.2105/AJPH.2009.180109.CrossRefPubMedPubMedCentral

Baker, C. K., Billhardt, K. A., Warren, J., Rollins, C., & Glass, N. E. (2010). Domestic violence, housing instability, and homelessness: A review of housing policies and program practices for meeting the needs of survivors. Aggression and Violent Behavior,15(6), 430–439. https://doi.org/10.1016/j.avb.2010.07.005.CrossRef

Barnes, P. F., El-Hajj, H., Preston-Martin, S., et al. (1996). Transmission of tuberculosis among the urban homeless. JAMA,275(4), 305–307.CrossRef

Barrow, S. M., Herman, D. B., Cordova, P., & Struening, E. L. (1999). Mortality among homeless shelter residents in New York City. American Journal of Public Health,89(4), 529–534.CrossRef

Beijer, U., & Andreasson, S. (2010). Gender, hospitalization and mental disorders among homeless people compared with the general population in Stockholm. European Journal of Public Health,20(5), 511–516. https://doi.org/10.1093/eurpub/ckq033.CrossRefPubMed

Beijer, U., Andreasson, S., Agren, G., & Fugelstad, A. (2011). Mortality and causes of death among homeless women and men in Stockholm. Scandinavian Journal of Public Health,39(2), 121–127. https://doi.org/10.1177/1403494810393554.CrossRefPubMed

Bernstein, R. S., Meurer, L. N., Plumb, E. J., & Jackson, J. L. (2015). Diabetes and hypertension prevalence in homeless adults in the United States: A systematic review and meta-analysis. American Journal of Public Health,105(2), e46–60. https://doi.org/10.2105/AJPH.2014.302330.CrossRefPubMedPubMedCentral

Brown, R. T., Kiely, D. K., Bharel, M., & Mitchell, S. L. (2012). Geriatric syndromes in older homeless adults. Journal of General Internal Medicine,27(1), 16–22. https://doi.org/10.1007/s11606-011-1848-9.CrossRefPubMed

Cheng, A. L., & Kelly, P. J. (2008). Impact of an integrated service system on client outcomes by gender in a national sample of a mentally ill homeless population. Gender Medicine,5(4), 395–404. https://doi.org/10.1016/j.genm.2008.10.003.CrossRefPubMed

Cheung, Y. B. (2002). Zero-inflated models for regression analysis of count data: A study of growth and development. Statistics in Medicine,21(10), 1461–1469. https://doi.org/10.1002/sim.1088.CrossRefPubMed

Chong, M. T., Yamaki, J., Harwood, M., et al. (2014). Assessing health conditions and medication use among the homeless community in Long Beach, California. Journal of Research in Pharmacy and Practice,3(2), 56–61. https://doi.org/10.4103/2279-042X.137073.CrossRef

Cohen, C. I., Teresi, J. A., & Holmes, D. (1988). The physical well-being of old homeless men. Journal of Gerontology,43(4), S121–S128. https://doi.org/10.1093/geronj/43.4.S121.CrossRefPubMed

Culhane, D. P., Gollub, E., Kuhn, R., & Shpaner, M. (2001). The co-occurrence of AIDS and homelessness: Results from the integration of administrative databases for AIDS surveillance and public shelter utilisation in Philadelphia. Journal of Epidemiology and Community Health,55(7), 515–520.CrossRef

Davidson C. (2016). Advance care planning for individuals experiencing homelessness. In: A Quarterly research review of the National HCH Council (vol. 4, no. 2).

Fazel, S., Geddes, J. R., & Kushel, M. (2014). The health of homeless people in high-income countries: Descriptive epidemiology, health consequences, and clinical and policy recommendations. Lancet,384(9953), 1529–1540. https://doi.org/10.1016/S0140-6736(14)61132-6.CrossRefPubMedPubMedCentral

Fazel, S., Khosla, V., Doll, H., & Geddes, J. (2008). The prevalence of mental disorders among the homeless in western countries: Systematic review and meta-regression analysis. PLoS Medicine,5(12), e225. https://doi.org/10.1371/journal.pmed.0050225.CrossRefPubMedPubMedCentral

Gama, H., Oliveira, L., Pereira, M. D. L., Azevedo, A., & Lunet, N. (2014). Use of medicines by homeless people in Porto, Portugal. Cadernos de Saude Publica,30(1), 207–212. https://doi.org/10.1590/0102-311x00006113.CrossRefPubMed

Garibaldi, B., Conde-Martel, A., & O'Toole, T. P. (2005). Self-reported comorbidities, perceived needs, and sources for usual care for older and younger homeless adults. Journal of General Internal Medicine,20(8), 726–730. https://doi.org/10.1111/j.1525-1497.2005.0142.x.CrossRefPubMedPubMedCentral

Goss, C. H., Rubenfeld, G. D., Park, D. R., Sherbin, V. L., Goodman, M. S., & Root, R. K. (2003). Cost and incidence of social comorbidities in low-risk patients with community-acquired pneumonia admitted to a public hospital. Chest,124(6), 2148–2155.CrossRef

Hibbs, J. R., Benner, L., Klugman, L., et al. (1994). Mortality in a cohort of homeless adults in Philadelphia. New England Journal of Medicine,331(5), 304–309. https://doi.org/10.1056/NEJM199408043310506.CrossRefPubMed

Hwang, S. W. (2001). Homelessness and health. CMAJ,164(2), 229–233.PubMedPubMedCentral

Hwang, S. W., Lebow, J. M., Bierer, M. F., O'Connell, J. J., Orav, E. J., & Brennan, T. A. (1998). Risk factors for death in homeless adults in Boston. Archives of Internal Medicine,158(13), 1454–1460.CrossRef

Jackman, S. (2015). Classes and methods for R developed in the Political Science Computational Laboratory (version 1.4. 9). Department of Political Science, Stanford University, Stanford, CA.

Jones, C. A., Perera, A., Chow, M., Ho, I., Nguyen, J., & Davachi, S. (2009). Cardiovascular disease risk among the poor and homeless: What we know so far. Current Cardiology Reviews,5(1), 69–77. https://doi.org/10.2174/157340309787048086.CrossRefPubMedPubMedCentral

Kushel, M. B., Evans, J. L., Perry, S., Robertson, M. J., & Moss, A. R. (2003). No door to lock: Victimization among homeless and marginally housed persons. Archives of Internal Medicine,163(20), 2492–2499. https://doi.org/10.1001/archinte.163.20.2492.CrossRefPubMed

Lebrun-Harris, L. A., Baggett, T. P., Jenkins, D. M., et al. (2013). Health status and health care experiences among homeless patients in federally supported health centers: Findings from the 2009 patient survey. Health Services Research,48(3), 992–1017. https://doi.org/10.1111/1475-6773.12009.CrossRefPubMed

Long, J. S., & Freese, J. (2001). Predicted probabilities for count models. The Stata Journal,1(1), 51–57.CrossRef

Metraux, S., Eng, N., Bainbridge, J., & Culhane, D. P. (2011). The impact of shelter use and housing placement on mortality hazard for unaccompanied adults and adults in family households entering New York City shelters: 1990–2002. Journal of Urban Health,88(6), 1091–1104. https://doi.org/10.1007/s11524-011-9602-5.CrossRefPubMedPubMedCentral

Montgomery, A. E., Szymkowiak, D., Marcus, J., Howard, P., & Culhane, D. P. (2016). Homelessness, unsheltered status, and risk factors for mortality: Findings from the 100 000 homes campaign. Public Health Reports,131(6), 765–772. https://doi.org/10.1177/0033354916667501.CrossRefPubMedPubMedCentral

Moon, S., & Shin, J. (2006). Health care utilization among Medicare-Medicaid dual eligibles: A count data analysis. BMC Public Health,6(1), 88. https://doi.org/10.1186/1471-2458-6-88.CrossRefPubMedPubMedCentral

Nielsen, S. F., Hjorthoj, C. R., Erlangsen, A., & Nordentoft, M. (2011). Psychiatric disorders and mortality among people in homeless shelters in Denmark: A nationwide register-based cohort study. Lancet,377(9784), 2205–2214. https://doi.org/10.1016/S0140-6736(11)60747-2.CrossRefPubMed

Nikoo, N., Motamed, M., Nikoo, M. A., et al. (2014). Chronic physical health conditions among homeless. Journal of Health Disparities Research & Practice,8(1), 5.

Nordentoft, M., & Wandall-Holm, N. (2003). 10 year follow up study of mortality among users of hostels for homeless people in Copenhagen. BMJ,327(7406), 81. https://doi.org/10.1136/bmj.327.7406.81.CrossRefPubMedPubMedCentral

O'Carroll, A., & O'Reilly, F. (2008). Health of the homeless in Dublin: Has anything changed in the context of Ireland's economic boom? European Journal of Public Health,18(5), 448–453. https://doi.org/10.1093/eurpub/ckn038.CrossRefPubMed

Padgett, D. K., & Struening, E. L. (1992). Victimization and traumatic injuries among the homeless: Associations with alcohol, drug, and mental problems. American Journal of Orthopsychiatry,62(4), 525–534.CrossRef

Pascual, J. C., Malagon, A., Arcega, J. M., et al. (2008). Utilization of psychiatric emergency services by homeless persons in Spain. General Hospital Psychiatry,30(1), 14–19. https://doi.org/10.1016/j.genhosppsych.2007.08.006.CrossRefPubMed

Paudyal, V., MacLure, K., Buchanan, C., Wilson, L., Macleod, J., & Stewart, D. (2017). 'When you are homeless, you are not thinking about your medication, but your food, shelter or heat for the night': Behavioural determinants of homeless patients' adherence to prescribed medicines. Public Health.,148, 1–8. https://doi.org/10.1016/j.puhe.2017.03.002.CrossRefPubMed

Pribish, A., Khalil, N., Mhaskar, R., Woodard, L., & Mirza, A. S. (2018). Chronic disease burden of the homeless: A descriptive study of student-run free clinics in Tampa Florida. Journal of Community Health. https://doi.org/10.1007/s10900-018-0580-3.CrossRef

Rhoades, H., Winetrobe, H., & Rice, E. (2014). Prescription drug misuse among homeless youth. Drug and Alcohol Dependence,138, 229–233. https://doi.org/10.1016/j.drugalcdep.2014.02.011.CrossRefPubMedPubMedCentral

Ritchey, F. J., Lagory, M., & Mullis, J. (1991). Gender differences in health risks and physical symptoms among the homeless. Journal of Health and Social Behavior,32(1), 33–48. https://doi.org/10.2307/2136798.CrossRefPubMed

Schanzer, B., Dominguez, B., Shrout, P. E., & Caton, C. L. (2007). Homelessness, health status, and health care use. American Journal of Public Health,97(3), 464–469. https://doi.org/10.2105/AJPH.2005.076190.CrossRefPubMedPubMedCentral

Schinka, J. A., Bossarte, R. M., Curtiss, G., Lapcevic, W. A., & Casey, R. J. (2016). Increased mortality among older veterans admitted to VA homelessness programs. Psychiatric Services (Washington, D. C.),67(4), 465–468. https://doi.org/10.1176/appi.ps.201500095.CrossRef

Sfeatcu, R., Dumitrache, A., Dumitrascu, L., Lambescu, D., Funieru, C., & Lupusoru, M. (2011). Aspects of oral and general health among a community center for the underserved. Journal of Medicine and Life,4(2), 168–171.PubMedPubMedCentral

Stergiopoulos, V., & Herrmann, N. (2003). Old and homeless: A review and survey of older adults who use shelters in an urban setting. Canadian Journal of Psychiatry,48(6), 374–380. https://doi.org/10.1177/070674370304800603.CrossRefPubMed

Sun, S., Irestig, R., Burstrom, B., Beijer, U., & Burstrom, K. (2012). Health-related quality of life (EQ-5D) among homeless persons compared to a general population sample in Stockholm County, 2006. Scandinavian Journal of Public Health,40(2), 115–125. https://doi.org/10.1177/1403494811435493.CrossRefPubMed

Team, R. C. (2013). R: A language and environment for statistical computing.

Tsai, J., Gelberg, L., & Rosenheck, R. A. (2019). Changes in physical health after supported housing: Results from the collaborative initiative to end chronic homelessness. J Gen Intern Med,34(9), 1703–1708. https://doi.org/10.1007/s11606-019-05070-y.CrossRef

Victor, C. R. (1997). The health of homeless people in Britain: A review. The European Journal of Public Health,7(4), 398–404.CrossRef

Vuong, Q. H. (1989). Likelihood ratio tests for model selection and non-nested hypotheses. Econometrica,57(2), 307–333. https://doi.org/10.2307/1912557.CrossRef

Weber, M., Thompson, L., Schmiege, S. J., Peifer, K., & Farrell, E. (2013). Perception of access to health care by homeless individuals seeking services at a day shelter. Archives of Psychiatric Nursing,27(4), 179–184. https://doi.org/10.1016/j.apnu.2013.05.001.CrossRefPubMed

Wickens, T. D., & Keppel, G. (2004). Design and analysis: A researcher's handbook. Upper Saddle River: Pearson Prentice-Hall.

Wiersma, P., Epperson, S., Terp, S., et al. (2010). Episodic illness, chronic disease, and health care use among homeless persons in Metropolitan Atlanta, Georgia, 2007. Southern Medical Journal,103(1), 18–24. https://doi.org/10.1097/SMJ.0b013e3181c46f79.CrossRefPubMed

Zeileis, A., Kleiber, C., & Jackman, S. (2008). Regression models for count data in R. Journal of Statistical Software,27(8), 1–25. https://doi.org/10.18637/jss.v027.i08.CrossRef

Zolopa, A. R., Hahn, J. A., Gorter, R., et al. (1994). HIV and tuberculosis infection in San Francisco's homeless adults Prevalence and risk factors in a representative sample. JAMA,272(6), 455–461.CrossRef

Zorza, J. (1991). Woman battering: A major cause of homelessness. Clearinghouse Review,25, 421.

Titel: Medical Comorbidities and Medication Use Among Homeless Adults Seeking Mental Health Treatment
verfasst von: Elizabeth Mayfield Arnold
Chance R. Strenth
Luke P. Hedrick
Robert C. Paterson
Julian Curiel
Amira E. Joseph
Thomas W. Brown
James N. Kimball
Publikationsdatum: 01.07.2020
Verlag: Springer US
Erschienen in: Community Mental Health Journal / Ausgabe 5/2020
Print ISSN: 0010-3853
Elektronische ISSN: 1573-2789
DOI: https://doi.org/10.1007/s10597-020-00552-4

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