{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,2]],"date-time":"2026-08-02T18:04:08Z","timestamp":1785693848379,"version":"3.56.0"},"reference-count":59,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,10,25]],"date-time":"2024-10-25T00:00:00Z","timestamp":1729814400000},"content-version":"vor","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Expectations"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Despite increased awareness of the detrimental relationship between homelessness and health, people experiencing homelessness remain an underserved population in health and social care research. Due to barriers affecting the accessibility of medicine and healthcare services, as well as reported competing priorities such as food and shelter, evidence has demonstrated that people experiencing homelessness are less likely to undergo routine examinations, receive diagnoses and adhere to prescribed medical treatments. To enhance service design and access for those experiencing homelessness, it is critical to better recognise, understand and address the barriers these individuals face. This meta\u2010ethnography aims to identify barriers, enablers and interventions to begin addressing this inequality gap.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic literature search was undertaken in October and re\u2010ran in December 2023 across four databases: MEDLINE, Embase, CINAHL and Scopus. Qualitative studies were included if they addressed barriers, enablers and interventions aimed at tackling medicines and health service inequalities among populations experiencing homelessness. Study quality was assessed using the Joanna Briggs Institute critical appraisal checklist. Data were synthesised using a meta\u2010ethnographic approach, as outlined by Noblit and Hare. The review was registered on PROSPERO (CRD42024511502) and performed according to PRISMA guidelines.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This meta\u2010ethnographic systematic review synthesised data from eight studies across multiple countries. Three overarching third\u2010order constructs (termed \u2018themes\u2019) were developed through reciprocal translation and centred around: recognising and acknowledging the discrimination, stigma and barriers experienced when using current services; exploring safe and practical use of medicines and the promotion of general health education and appreciating strategies to tackle inequalities, namely community outreach programmes designed for homeless communities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This work highlighted the barriers, enablers and interventions that sought to address the inequalities affecting people experiencing homelessness in accessing medication and healthcare services. Future research should utilise lived\u2010experience narratives and co\u2010design to further explore ways to tackle wider healthcare accessibility inequalities for this minoritised population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial Registration<\/jats:title><jats:p>Not applicable, as this is a systematic review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patient or Public Contribution<\/jats:title><jats:p>Public contributors (minority research champions and one public health research champion, H.K.G. and T.G.) informed and shaped this project during study design and conceptualisation. They helped to ensure that the study was conducted, and the findings were reported with sensitivity.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hex.70076","type":"journal-article","created":{"date-parts":[[2024,10,25]],"date-time":"2024-10-25T12:50:34Z","timestamp":1729860634000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Tackling Inequalities in Access to Medicines for People Experiencing Homelessness: A Meta\u2010Ethnography and Qualitative Systematic Review"],"prefix":"10.1111","volume":"27","author":[{"given":"Tasnim","family":"Begum","sequence":"first","affiliation":[{"name":"School of Pharmacy Newcastle University Newcastle upon Tyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kylie","family":"Murrell","sequence":"additional","affiliation":[{"name":"Population Health Sciences Institute Newcastle University Newcastle upon Tyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9523-4760","authenticated-orcid":false,"given":"Anna","family":"Robinson\u2010Barella","sequence":"additional","affiliation":[{"name":"School of Pharmacy Newcastle University Newcastle upon Tyne UK"},{"name":"Population Health Sciences Institute Newcastle University Newcastle upon Tyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,10,25]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/medu.12132"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2524.2008.00793.x"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/jan.12675"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2013.301586"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11524-011-9562-9"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/cl2.1154"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10464-011-9444-z"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.104.510826"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61132-6"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.12968\/bjhc.2016.22.4.215"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijpp.12520"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1089\/apc.2011.0169"},{"issue":"3","key":"e_1_2_13_14_1","article-title":"How Do Health Inequalities Intersect With Housing and Homelessness","volume":"15","author":"Ranmal R.","year":"2021","journal-title":"European Journal of Homelessness"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph14121535"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61133-8"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.4324\/9781003295495-3"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1080\/02673037.2019.1642452"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12939-021-01409-2"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)31959-1"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.b2535"},{"key":"e_1_2_13_22_1","first-page":"359","article-title":"Evaluation of PICO as a Knowledge Representation for Clinical Questions","volume":"2006","author":"Huang X.","year":"2006","journal-title":"AMIA. 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