Assessing health literacy and polypharmacy in a homeless substance abuse treatment facility Nathan D. Culver, Pharm.D., BCPS; Camille Agosto, Student Pharmacist; Hera Saleem, Student Pharmacist; Amanda Welk, Student Pharmacist; Ashley Yee, Student Pharmacist Notre Dame of Maryland University School of Pharmacy Correspondence: Nathan Culver, Pharm.D.,BCPS Notre Dame of Maryland University School of Pharmacy 4701 N Charles Street Baltimore, Maryland According to the 2013 Annual Homeless Report (AHAR), 600,000 persons remain homeless in the United States. The National Law Center of Homelessness and Poverty estimates that the number of homeless is closer to 3.5 million. 1 Poor health is also a common finding among those that are homeless. Of the over 600,000 homeless persons represented in the U.S. Department of Housing and Development survey, 20% are reported as severely mentally ill and 22% as chronic substance abusers. It is estimated that approximately 40% of homeless persons have at least one chronic disease. This number climbs to nearly 80% in those with chronic substance abuse or veterans who are homeless. 1 In a single research study by Christensen and Grace, health literacy of 45 persons was assessed using a Rapid Estimate of Adult Literacy (REALM) score. Results find 76% of persons that were homeless scored below the 7 th to 8 th grade reading level using the REALM score. 2 INTRODUCTION OBJECTIVES LIMITATIONS REFERENCES 1."The Annual Homeless Assessment Report to Congress (2013)", U.S. Department of Housing and Urban Development, November Christensen R,& Grace G. The prevalence of low literacy in an indigent psychiatric population. Psychiatric Services, 50, 262– D’Amore, J., Hung, O., Chiang,W., & Goldfrank, L. (2001). The epidemiology of the homeless population and its impact on an urban emergency department. Academy of Emergency Medicine, 8, 1051– Parker, R., Ratzan, S., & Lurie, N. (2003). Health literacy: A policy challenge for advancing high-quality health care. Health Affairs, 22, 147– Coe et al. (2012). Medication adherence challenges among patients experiencing homelessness in a behavioral health clinic. 6.Berkman, N. D., DeWalt, D. A., Pignone, M. P., Sheridan, S. L., Lohr, K. N., Lux, L., et al. (2004). Literacy and Health Outcomes (AHRQ Publication No. 04-E007-2). Rockville, MD: Agency for Healthcare Research and Quality. Study design  Retrospective cohort study Subjects  28 men over the age of 18 who were residents or graduates of HUM still living or working at the faculty. Data analysis  Descriptive statistics Committee approval  Notre Dame of Maryland University School of Pharmacy IRB expedited review CONCLUSIONS  Of the 28 participants, 64% were at risk for poor health literacy, defined as a score of 6 or less on the REALM-R test.  The most common comorbidities in this population included mental illness, diabetes, and hypertension.  Over half of the men participating were prescribed <3 medications.  Our findings are consistent with the previously published literature. METHODS RESULTS DISCLOSURE  The authors of this project have no actual or potential conflicts of interest.  Retrospective analysis  Small patient population  Single center  To complete an analysis of health literacy and polypharmacy in homeless men at Helping Up Mission, a substance abuse treatment facility.  To design future interventions to target health literacy programming to improve health outcomes in the homeless population. Table 1: Population Characteristics (n=28) Past Medical History Hypertension43% (n=12) Mental Illness39% (n=11) Diabetes18% (n=5) Pain14% (n=4) GERD14% (n=4) FUTURE IMPLICATIONS  Developing programming to improve health literacy among the homeless population.  Projects will focus on identified patient medical histories and target medications used to treat these disease states.  Effectiveness of subsequent will be assessed utilizing pre- and post-testing.  Health education will be implemented utilizing an interdisciplinary approach throughout various parts of the program at Helping Up Mission.