OBJECTIVES: It is estimated that 895,000 people in Europe are homeless or have insecure housing (HIH), which means approximately 1 in 600 people are living rough, in temporary accommodation or shelters every night. The difficulties in documenting HIH mean that this figure is likely to be an underestimate. HIH is associated with multiple comorbidities that add to the burdens of HIH, in particular difficulties in accessing medical care, paying for medication and stigma, all of which combine to have a negative impact on quality of life. This study reports on interventions that improve quality of life (QoL) in the HIH population.

METHODS: We conducted a systematic search for studies on quality of life associated with HIH between 2013-2024 and indexed 320 relevant abstracts in an online evidence mapper tool (www.evidencemapper.co.uk).

RESULTS: Comorbidities in HIH populations were reported in 289 studies, of which mental health issues were the most common. Despite this, no studies were identified that assessed the QoL impact of pharmacological interventions for mental health disorders in people specifically with HIH. However, housing support interventions were effective at improving QoL in these populations. In HIH populations with HIV, providing secure housing improved SF-12 physical component scores at 12 months, however neither improvements in housing nor antiretroviral HIV treatment improved mental component scores at 12 months. In the alcohol-dependent HIH population, managed alcohol programs improved both mental and physical QoL scores.

CONCLUSIONS: Given the size of the problem there is a major gap in the evidence on how far pharmacological interventions to address comorbidities can improve QoL in HIH populations. Research suggests improving housing security is a key driver of improved QoL in people who are HIH, but more research is needed on more easily provided interventions to improve mental health in this population while they wait for more secure housing.