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Lookup NU author(s): Kylie Murrell, Dr Anna Robinson-BarellaORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
IntroductionDespite increased awareness of the detrimental relationship between homelessness and health, people experiencing homelessness remain an underserved population in health and social care research. Due to barriers affecting the accessibility of medicine and healthcare services, as well as reported competing priorities such as food and shelter, evidence has demonstrated that people experiencing homelessness are less likely to undergo routine examinations, receive diagnoses and adhere to prescribed medical treatments. To enhance service design and access for those experiencing homelessness, it is critical to better recognise, understand and address the barriers these individuals face. This meta-ethnography aims to identify barriers, enablers and interventions to begin addressing this inequality gap.MethodsA systematic literature search was undertaken in October and re-ran in December 2023 across four databases: MEDLINE, Embase, CINAHL and Scopus. Qualitative studies were included if they addressed barriers, enablers and interventions aimed at tackling medicines and health service inequalities among populations experiencing homelessness. Study quality was assessed using the Joanna Briggs Institute critical appraisal checklist. Data were synthesised using a meta-ethnographic approach, as outlined by Noblit and Hare. The review was registered on PROSPERO (CRD42024511502) and performed according to PRISMA guidelines.ResultsThis meta-ethnographic systematic review synthesised data from eight studies across multiple countries. Three overarching third-order constructs (termed ‘themes’) were developed through reciprocal translation and centred around: recognising and acknowledging the discrimination, stigma and barriers experienced when using current services; exploring safe and practical use of medicines and the promotion of general health education and appreciating strategies to tackle inequalities, namely community outreach programmes designed for homeless communities.ConclusionThis work highlighted the barriers, enablers and interventions that sought to address the inequalities affecting people experiencing homelessness in accessing medication and healthcare services. Future research should utilise lived-experience narratives and co-design to further explore ways to tackle wider healthcare accessibility inequalities for this minoritised population.Patient or Public ContributionPublic contributors (minority research champions and one public health research champion, H.K.G. and T.G.) informed and shaped this project during study design and conceptualisation. They helped to ensure that the study was conducted, and the findings were reported with sensitivity.
Author(s): Begum T, Murrell K, Robinson-Barella A
Publication type: Article
Publication status: Published
Journal: Health Expectations
Year: 2024
Volume: 27
Issue: 5
Print publication date: 25/10/2024
Online publication date: 25/10/2024
Acceptance date: 08/10/2024
Date deposited: 31/10/2024
ISSN (print): 1369-6513
ISSN (electronic): 1369-7625
Publisher: Wiley-Blackwell Publishing Ltd.
URL: https://doi.org/10.1111/hex.70076
DOI: 10.1111/hex.70076
Data Access Statement: The data that support the findings of this study are available from the corresponding author upon reasonable request.
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