Does the Intervention of Identifying Homeless Clients Who Should Receive Lipid Altering Therapy Decrease the Occurrence of Cardiovascular Events?

Abstract

One hundred and six homeless clients were identified between August 1, 1997 and March 31, 1998, via a simple medication profile screening of individuals who could potentially benefit from risk factor modification with lipid altering therapy. Medication profiles were reviewed for homeless clients housed at the New England Shelter for Homeless Veterans. Clients on lipid altering therapy (Group I) were compared to those not on lipid altering therapy (Group II) but who might benefit from therapy based on a review of their drug regimen. Following an interview with the client, an intervention letter was sent to the health care practitioner identifying those individuals who might benefit from lipid altering therapy. Descriptive statistics described client demographics and the Fisher's Exact Test compared the occurrence of cardiovascular events between the two groups. Interviews were conducted in 21 clients. Only 4 practitioners responded to the intervention letter. All Group I clients suffered at least 1 cardiovascular event during the study period. However, the occurrence of cardiovascular events was greater in Group II (not significant). Although it was easy to identify clients for lipid altering therapy, the challenge of provision and continuity of appropriate therapy to reduce cardiovascular events in this population remains.