title: Psychopharmacologic Services for Homeless Veterans: Comparing Psychotropic Prescription Fills Among Homeless and Non-Homeless Veterans with Serious Mental Illness.
abstract: Using national Veterans Health Administration (VHA) administrative data, this study evaluated differences in psychotropic medication use between homeless and non-homeless adults with serious mental illness (SMI) who used VHA services in 2010. The adjusted mean number of psychotropic prescription fills associated with homeless individuals were identified using regression models adjusted for socio-demographics, diagnoses, and use of health services. Of the 876,989 individuals with SMI using VHA services, 7.2 % were homeless at some time during 2010. In bivariate analysis, homeless individuals filled more psychotropic medication prescriptions compared with non-homeless individuals. However, after adjusting for potentially confounding variables, homeless individuals were found to have filled 16.2 % fewer prescriptions than non-homeless individuals when all psychotropics were analyzed together (F = 6947.1, p < .001) and for most individual classes of psychotropics. Greater use of residential/inpatient mental health services by the homeless was the most important single factor associated with filling more psychotropic prescriptions than non-homeless individuals.
authors.affiliation: VA New England Mental Illness Research, Education, and Clinical Center, 950 Campbell Ave., West Haven, CT, 06516, USA. eric.hermes@yale.edu.|Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA. eric.hermes@yale.edu.
authors.forename: Eric
authors.initials: E
authors.lastname: Hermes
authors.affiliation: VA New England Mental Illness Research, Education, and Clinical Center, 950 Campbell Ave., West Haven, CT, 06516, USA. Robert.Rosenheck@yale.edu.|Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA. Robert.Rosenheck@yale.edu.
authors.forename: Robert
authors.initials: R
authors.lastname: Rosenheck
mesh_terms: D000328:Adult; D000368:Aged; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005260:Female; D006703:Ill-Housed Persons / Q000523:psychology / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D008605:Mental Health Services / Q000706:statistics & numerical data; D008875:Middle Aged; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D012044:Regression Analysis; D012114:Residential Treatment; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology / Q000706:statistics & numerical data*; D058014:Veterans Health / Q000706:statistics & numerical data*
chemical_list: D011619:Psychotropic Drugs
keywords: Homeless persons; Pharmaco-epidemiology; Pharmacology; Residential treatment; Veteran Health Administration; Veterans