Hostname: page-component-8448b6f56d-dnltx Total loading time: 0 Render date: 2024-04-18T12:05:19.971Z Has data issue: false hasContentIssue false
  • English
  • Français

Evidence-Based Approach for Disaster Preparedness Authorities to Inform the Contents of Repositories for Prescription Medications for Chronic Disease Management and Control

Published online by Cambridge University Press:  28 June 2012

David W. Brown ,
Stacy L. Young ,
Michael M. Engelgau  and
George A. Mensah
David W. Brown*
Affiliation:
National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia USA
Stacy L. Young
Affiliation:
Independent contractor, Decatur, Georgia USA
Michael M. Engelgau
Affiliation:
National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia USA
George A. Mensah
Affiliation:
National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia USA
*
Centers for Disease Control and Prevention4770 Buford Highway NE (MS K67)Atlanta, Georgia 30341USA E-mail: dbrown6@cdc.gov
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction:

Chronic diseases are major causes of death and disability and often require multiple prescribed medications for treatment and control. Public health emergencies (e.g., disasters due to natural hazards) that disrupt the availability or supply of these medications may exacerbate chronic disease or even cause death.

Problem:

A repository of chronic disease pharmaceuticals and medical supplies organized for rapid response in the event of a public health emergency is desirable. However, there is no science base for determining the contents of such a repository. This study provides the first step in an evidence-based approach to inform the planning, periodic review, and revision of repositories of chronic disease medications.

Methods:

Data from the 2004 National Hospital Ambulatory Medical Care Survey (NHAMCS) were used to examine the prescription medication needs of persons presenting to US hospital emergency departments for chronic disease exacerbations. It was assumed that the typical distribution of cases for an emergency department will reflect the patient population treated in the days after a public health emergency. The estimated numbers of prescribed drugs for chronic conditions that represent the five leading causes of death, the five leading primary diagnoses for physician office visits, and the five leading causes of disease burden assessed by disability-adjusted life years are presented.

Results:

The 2004 NHAMCS collected data on 36,589 patient visits that were provided by 376 emergency departments. Overall, the five drug classes mentioned most frequently for emergency department visits during 2004 were narcotic analgesics (30.7 million), non-steroidal anti-inflammatory drugs (25.2 million), non-narcotic analgesics (15.2 million), sedatives and hypnotics (10.4 million), and cephalosporins (8.2 million). The drug classes mentioned most frequently for chronic conditions were: (1) for heart disease, antianginal agents/vasodilators (715,000); (2) for cancer, narcotic analgesics (53,000); (3) for stroke, non-narcotic analgesics (138,000); (4) for chronic obstructive pulmonary disease, anti-asthmatics/bronchodilators (3.2 million); and (5) for diabetes, hypoglycemic agents (261,000). Ten medication categories were common across four or more chronic conditions.

Conclusions:

Persons with chronic diseases have an urgent need for ongoing care and medical support after public health emergencies. These findings provide one evidence-based approach for informing public health preparedness in terms of planning for and review of the prescription medication needs of clinically vulnerable populations with prevalent chronic disease.

Keywords

chronic diseasedisaster planningemergenciesmedication systems
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 23 , Issue 5 , October 2008 , pp. 447 - 457
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Hoyert, DL, Heron, MP, Murphy, SL, Kung, HC: Deaths: Final data for 2003. Natl Vital Stat Rep 2006;54:1–120.Google ScholarPubMed
2.World Health Organization: Preventing Chronic Diseases: A Vital Investment. Geneva: World Health Organization, 2005.Google Scholar
3.Wu, S, Green, A: Projection of Chronic Illness Prevalence and Cost Inflation. Santa Monica, California: RAND Health, 2000.Google Scholar
4.Wolff, JL, Starfield, B, Anderson, G: Prevalence, expenditures, and complications of multiple chronic conditions in the elderly. Arch Intern Med 2002;162:2269–2276.CrossRefGoogle ScholarPubMed
5.Mokdad, AH, Mensah, GA, Posner, SF, et al. : When chronic conditions become acute: Prevention and control of chronic diseases and adverse health outcomes during natural disasters. Prev Chronic Dis 2005;2(Spec no.):A04.Google ScholarPubMed
6.Ford, ES, Mokdad, AH, Link, MW, et al. : Chronic disease in health emergencies: In the eye of the hurricane. Prev Chronic Dis 2006;3:A46.Google ScholarPubMed
7.Azziz-Baumgartner, E, Wolkin, A, Sanchez, C., et al. : Impact of Hurricane Ivan on pharmacies in Baldwin County, Alabama. J Am Pharm Assoc 2005;45:670–675.CrossRefGoogle Scholar
8.Baggett, J: Florida disasters and chronic disease conditions. Prev Chronic Dis 2006;3:A66. (Letter to the editor).Google ScholarPubMed
9.Hsu, EB, Casani, JA, Romanosky, A, Millin, MG: Are regional hospital pharmacies prepared for public health emergencies? Biosecur Bioterror 2006;4(3):237–243.CrossRefGoogle ScholarPubMed
10.Stroupe, KT, Murray, MD, Stump, TE, Callahan, CM: Association between medication supplies and healthcare costs in older adults from an urban healthcare system. J Am Geriatr Soc 2000;48:760–768.Google ScholarPubMed
11.Rosenthal, MS, Klein, K, Cowling, K, et al. : Disaster modeling: Medication resources required for disaster team response. Prehospital Disaster Med 2005;20:309–315.CrossRefGoogle ScholarPubMed
12.Centers for Disease Control and Prevention (CDC): Epidemiologic assessment of the impact of four hurricanes–Florida, 2004. MMWR 2005;54:693–697.Google Scholar
13.CDC: Surveillance for injuries and illnesses and rapid health-needs assessment following hurricanes Marilyn and Opal, September–October 1995. MMWR 1996;45:81–85.Google Scholar
14.CDC: Rapid community health and needs assessments after Hurricanes Isabel and Charley–North Carolina, 2003-2004. MMWR 2004;53:840–842.Google Scholar
15.McCaig, LF, McLemore, T: Plan and operation of the National Hospital Ambulatory Medical Survey. Series 1: Programs and collection procedures. Vital Health Stat 1 1994;34:1–78.Google Scholar
16.Hing, E, Cherry, DK, Woodwell, DA: National Ambulatory Medical Care Survey: 2003 summary. Adv Data 2005;365:1–48.Google Scholar
17.Lopez, AD, Mathers, CD, Ezzati, M, et al. : Global Burden of Disease and Risk Factors. Washington, DC: The World Bank, 2006, p 8.Google ScholarPubMed
18.de Ville de Goyet, C., Marti, RZ, Osorio, C: Natural Disaster Mitigation and Relief. In: Jamison, DT, Breman, JG, Measham, AR, et al. (eds), Disease Control Priorities in Developing Countries. 2d ed.New York: Oxford University Press, 2006, pp 1147–1162.Google Scholar
19.Sharma, AJ, Weiss, EC, Young, SL, et al. : Chronic disease and related conditions at emergency-treatment facilities after Hurricane Katrina–New Orleans area, Louisiana. Disaster Med Public Health Preparedness In Press.Google Scholar
20.Brodie, M, Weltzien, E, Altman, D, et al. : Experiences of hurricane Katrina evacuees in Houston shelters: Implications for future planning. Am J Public Health 2006;96:1402–1408.Google ScholarPubMed
21.Jhung, MA, Shehab, N, Rohr-Allegrini, C: Chronic disease and disasters: Medication demands of Hurricane Katrina evacuees. Am J Prev Med 2007;33:207–210.Google ScholarPubMed