Purpose: To detect high blood pressure (HBP) among homeless adults in an emergency shelter and triage these patients into primary care clinics. Methods: We performed a retrospective chart review of 163 consecutive adults presenting at a shelter clinic and identified those with HBP, defined as systolic blood pressure ³ 140 or diastolic pressure ³ 90 during one or more visits. Results: Thirty-six of 163 adults (22%) had HBP. Respectively, 0% (0/30), 19% (20/106), and 59% (16/27) of those aged 18-29, 30-49, and 50-over, had HBP. Nineteen patients (53%) were unaware of a history of hypertension. Thirty patients (83%) were not being treated for hypertension. Twenty-seven patients (75%) were referred to a primary care clinic; nineteen (70%) kept the appointment. In a multivariate logistic regression with clinical and demographic variables, age and number of visits to the shelter clinic predicted completed appointments, but level of HBP did not. Conclusions: HBP is common among homeless persons over age 30 seeking medical care in an emergency shelter. The majority of persons were unaware that they had HBP and had not been evaluated or received treatment. Referral and completed appointments to primary care clinics were not optimal, especially for younger patients. This study prompted us to a) screen all shelter residents for HBP; b) develop strategies to repeat blood pressure measurements over 3 days; and c) educate shelter physicians to develop treatment plans that consider the interaction between features of homeless life and individual treatment needs.
Learning Objectives: At the conclusion of this session, the participant will be able to identify barriers to the management of elevated blood pressure of homeless persons in an emergency shelter and to describe approaches to overcome these barriers
Keywords: Homeless Health Care, Hypertension
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.