Barriers to Outpatient Respiratory Therapy Among Adult Residents of Emergency Shelters
Authors: Daniel A. Dworkis, Stacy S. Brown, Jessie M. Gaeta, Jeffrey W. Brown, Matthew H. Gonzalez
Journal: Annals of Internal Medicine (2012)

Letters6 November 2012Barriers to Outpatient Respiratory Therapy Among Adult Residents of Emergency SheltersDaniel A. Dworkis, ScB, Stacy S. Brown, BA, Jessie M. Gaeta, MD, Jeffrey W. Brown, MD, PhD, and Matthew H. Gonzalez, MDDaniel A. Dworkis, ScBFrom Boston University School of Medicine, Boston, MA 02118; University of Pittsburgh Medical Center, Pittsburgh, PA 15213; and The Johns Hopkins Hospital, Baltimore, MD 21287.Search for more papers by this author, Stacy S. Brown, BAFrom Boston University School of Medicine, Boston, MA 02118; University of Pittsburgh Medical Center, Pittsburgh, PA 15213; and The Johns Hopkins Hospital, Baltimore, MD 21287.Search for more papers by this author, Jessie M. Gaeta, MDFrom Boston University School of Medicine, Boston, MA 02118; University of Pittsburgh Medical Center, Pittsburgh, PA 15213; and The Johns Hopkins Hospital, Baltimore, MD 21287.Search for more papers by this author, Jeffrey W. Brown, MD, PhDFrom Boston University School of Medicine, Boston, MA 02118; University of Pittsburgh Medical Center, Pittsburgh, PA 15213; and The Johns Hopkins Hospital, Baltimore, MD 21287.Search for more papers by this author, and Matthew H. Gonzalez, MDFrom Boston University School of Medicine, Boston, MA 02118; University of Pittsburgh Medical Center, Pittsburgh, PA 15213; and The Johns Hopkins Hospital, Baltimore, MD 21287.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-157-9-201211060-00025 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Chronic lower respiratory disease is an important source of morbidity and, collectively, is a leading cause of death in the United States (1). That is especially true for the homeless adult population, in whom the prevalence of chronic lower respiratory disease is approximately 15% to 30% (2, 3). Furthermore, pulmonary disease confers an incompletely understood 1.5-fold greater risk for death in this demographic group than in persons with stable housing (4).Objective: To identify the barriers to outpatient management of chronic lower respiratory disease among residents of emergency shelters.Case Report: A 58-year-old Mexican immigrant was admitted to our ...References1. Kochanek KD, Xu J, Murphy BS, Minino AM, Kung HC. Deaths: Preliminary Data for 2010. National Vital Statistics Reports; vol 60, no 4. Hyattsville, MD: National Center for Health Statistics; 2012. Accessed at www.cdc.gov/nchs/data/nvsr/nvsr60/nvsr60_04.pdf on 11 March 2012. Google Scholar2. Badiaga S, Richet H, Azas P, Zandotti C, Rey F, Charrel R, et al. Contribution of a shelter-based survey for screening respiratory diseases in the homeless. Eur J Public Health. 2009;19:157-60. [PMID: 19164432] CrossrefMedlineGoogle Scholar3. Snyder LD, Eisner MD. Obstructive lung disease among the urban homeless. Chest. 2004;125:1719-25. [PMID: 15136382] CrossrefMedlineGoogle Scholar4. Hwang SW, Lebow JM, Bierer MF, O'Connell JJ, Orav EJ, Brennan TA. Risk factors for death in homeless adults in Boston. Arch Intern Med. 1998;158:1454-60. [PMID: 9665356] CrossrefMedlineGoogle Scholar5. Dolovich MB, Ahrens RC, Hess DR, Anderson P, Dhand R, Rau JL, et al; American College of Chest Physicians. Device selection and outcomes of aerosol therapy: Evidence-based guidelines: American College of Chest Physicians/American College of Asthma, Allergy, and Immunology. Chest. 2005;127:335-71. [PMID: 15654001] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Boston University School of Medicine, Boston, MA 02118; University of Pittsburgh Medical Center, Pittsburgh, PA 15213; and The Johns Hopkins Hospital, Baltimore, MD 21287.Disclosures: Dr. Dworkis: Other: Unpaid member of the advisory board of the Massachusetts Housing and Shelter Alliance. Dr. Gaeta: Consultancy: Massachusetts Housing and Shelter Alliance. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByNeighborhood and the Built Environment 6 November 2012Volume 157, Issue 9Page: 679-680KeywordsAdultsConflicts of interestHypoxiaInpatientsLungsMedical servicesMorbidityOutpatientsOxygenPulmonary diseases ePublished: 6 November 2012 Issue Published: 6 November 2012 CopyrightCopyright © 2012 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...