Table 3.

Summary of recommendations for care of homeless patients with rheumatic and musculoskeletal disorders

Issue	Recommendation	Type of recommendation
Access to healthcare	Universal healthcare for all	Aspirational
Disparities in housing, income, education, and transportation	Governmental policy and bolstered social programs to reduce disparities and provide equal opportunity for the homeless	Aspirational
Disparities in housing, income, education, and transportation	Enhanced social services in mobile clinics, continuity clinics, hospitals	Practical
Disparities in housing, income, education, and transportation	Training and incentivizing providers to link patients to resources and to advocate for policies that improve disparities	Practical
Comorbid mental illness and substance abuse	Training providers on establishing rapport and addressing common comorbidities. Mental health and substance abuse services integrated into clinical settings	Practical
Disease progression causing disability	Early arthritis identification and treatment through “Street Medicine” and screening during Primary Care appointments	Practical
Inability to take medications	Long-acting medications. Delivery and storage of medications in shelters	Practical
Adherence to clinic appointments	Involving friends, family, volunteers, and social workers to help patient attend appointments. Making walk-in appointments and rescheduling appointments easy. Innovative adaptation, development of, and utilization of “Street Medicine” programs, subjective outcomes assessments, “tele-health,” information technology, care extenders, and artificial intelligence to communicate with and care for homeless patients	Practical