[Morbidity spectrum and drug therapy of homeless persons in Munich].

In Germany there are currently approx. 200,000 homeless single people, and the trend is rising. As a result of the situation in which they find themselves, many of these persons are ill and in need of medical treatment. A study was performed in Munich/Germany, focussing on a medical practice providing care for the homeless, to investigate their illnesses and pharmacological therapy. The medical practice was located in a municipal shelter. Each year about 350 different destitute homeless men--about 15 per cent of all single homeless people in Munich--were cared for. The men, whose ages ranged from about 17 to 74 years were single and the majority lived in shelters, bed and breakfast accommodations, or shared apartments. About ten per cent lived on the street. For the study, 171 randomly selected medical records were analysed for the period of July 1994 to June 1995. The homeless men suffered principally from the following illnesses: psychiatric illnesses (36%), infectious and parasitic diseases (31%), skin diseases (30%), injuries (29%), diseases of the skeleton, of the muscles and of the connective tissues (28%), diseases of the respiratory organs (27%), cardiovascular diseases (24%), and diseases of the digestive organs (17%). Seventy-five per cent of the patients received drug treatment. In the case of 37% of the patients, wounds were treated and dressed in the medical practice itself. The most frequently prescribed drugs were: analgesics (12%), antibiotics (10%), antihypertensives (10%), gastrointestinal treatments (9%), treatments for colds (9%), and dermatopharmacological preparations (6%). It was surprising that only 16% of the psychic ill patients were treated with drugs, while over 60% of the other illnesses were mostly treated pharmacologically. The interaction with alcohol was the reason for that. The study showed that the practice did not sufficiently reach women and homeless people living on the street. The homeless situation, the personal and social difficulties faced by the homeless and the frequent misuse of alcohol caused many problems in medical treatment, such as low compliance. Special medical institutions like the Munich medical practice are capable of handling these problems. Co-operation with social relief organisations helps to improve the overall situation of the patient and also improves his state of health. These medical institutions are useful and necessary for providing good health care for the social fringe population, such as the homeless are.