Pharmacy Homeless Outreach Engagement Non-medical Independent prescribing Rx (PHOENIx) community pharmacy based pilot randomised controlled trial

Randomised controlled trials (RCTs) aiming to address the multiple health and social challenges of people experiencing homelessness (PEH) are lacking. Here we report the findings from a multicentre, open, pilot RCT. The intervention involved Independent Prescriber Pharmacist from the National Health Service working on outreach in partnership with dedicated workers from Homeless Voluntary Charity or Social Enterprises (HVCSEs) (Pharmacist and third sector charity worker integrated Homeless Outreach Engagement Non-medical Independent prescriber Rx’-PHOENIx) in low threshold HVCSE venues or temporary accommodation addressing PEH participants’ health and wider needs through repeated outreach. The trial aimed to investigate whether sufficient numbers of participants could be recruited, retained, the intervention delivered as planned, and sufficient data collected to inform a subsequent definitive RCT. Clinical outcomes were also collected at follow up (six month). Participants were recruited from five community pharmacies and nearby venues in urban centres of Glasgow-Scotland and Birmingham-England, then randomised one-to-one into PHOENIx intervention in addition to usual care (UC) or UC only. A-priori progression criteria were achieved: 55% of those assessed as eligible were recruited; at six months, 72% remained in the study, 91% had emergency department and mortality data available and 72% completed questionnaire booklets. Fifty three percent of participants received at least 50% of the planned PHOENIx intervention consultations (in-person or phone) at six months. Signs of improvement in clinical outcomes in the PHOENIx group included fewer ambulance call-outs, ED visits and hospitalisations; higher outpatient attendances; and higher scores on self-reported health-related quality of life. A definitive RCT is merited. Study protocol: ISRCTN 88146807