Brief report
Chronic Disease and Disasters: Medication Demands of Hurricane Katrina Evacuees

https://doi.org/10.1016/j.amepre.2007.04.030Get rights and content

Background

Preparing for natural disasters has historically focused on treatment for acute injuries, environmental exposures, and infectious diseases. Many disaster survivors also have existing chronic illness, which may be worsened by post-disaster conditions. The relationship between actual medication demands and medical relief pharmaceutical supplies was assessed in a population of 18,000 evacuees relocated to San Antonio TX after Hurricane Katrina struck the Gulf Coast in August 2005.

Methods

Healthcare encounters from day 4 to day 31 after landfall were monitored using a syndromic surveillance system based on patient chief complaint. Medication-dispensing records were collected from federal disaster relief teams and local retail pharmacies serving evacuees. Medications dispensed to evacuees during this period were quantified into defined daily doses and classified as acute or chronic, based on their primary indications.

Results

Of 4229 categorized healthcare encounters, 634 (15%) were for care of chronic medical conditions. Sixty-eight percent of all medications dispensed to evacuees were for treatment of chronic diseases. Cardiovascular medications (39%) were most commonly dispensed to evacuees. Thirty-eight percent of medication doses dispensed by federal relief teams were for chronic care, compared to 73% of doses dispensed by retail pharmacies. Federal disaster relief teams supplied 9% of all chronic care medicines dispensed.

Conclusions

A substantial demand for drugs used to treat chronic medical conditions was identified among San Antonio evacuees, as was a reliance on retail pharmacy supplies to meet this demand. Medical relief pharmacy supplies did not consistently reflect the actual demands of evacuees.

Introduction

On August 29, 2005, Hurricane Katrina struck the Gulf Coast, forcing the relocation of more than 18,000 Louisiana and Mississippi residents into mass evacuee centers in San Antonio, TX. Disaster-related morbidity from acute traumatic injuries, environmental exposures, and infectious diseases was expected, and medical relief plans focused on these well-recognized consequences of natural disasters.1 Although survivor needs are likely incident specific, recent evidence suggests that post-disaster medical care often involves few patients with acute conditions2, 3 and many patients with low-acuity complaints.4, 5, 6

In this report, disease surveillance and pharmaceutical use data from a group of displaced Hurricane Katrina survivors are presented. These data describe the survivors’ medication requirements and the extent to which these needs were met by federal disaster relief teams and local retail pharmacies.

Section snippets

Methods

The primary outcomes of interest for this ecological study were medications dispensed to Hurricane Katrina evacuees residing in a San Antonio evacuee center from September 2nd through the 21st, 2005. During this period, the Centers for Disease Control and Prevention assisted the San Antonio Metropolitan Health District with disease surveillance in four primary evacuee centers. Health care was provided to evacuees in one evacuee center by the Texas-1 and Florida-2 disaster medical assistance

Results

Daily evacuee census ranged from 2020 to 6219 people (median = 3707). The median number of healthcare encounters per day was 218 (5% of evacuee population), with a range of 5 to 574 encounters (<1% to 13% of evacuee population). Of 5030 evacuee healthcare encounters captured by the syndromic surveillance system, 4229 (84%) were categorized;b 2834 (67%) were for acute care conditions, 634 (15%) were explicitly for care of chronic medical conditions, and 761 (18%) were for routine care, including

Conclusion

Hurricane evacuees in San Antonio relied on retail pharmacies to meet the majority of their medication needs. Although evacuees seeking care for chronic medical complaints accounted for relatively few healthcare encounters (15%), their medication needs constituted 68% of all DDDs dispensed. The DMATs deployed to San Antonio appeared better equipped to meet the acute care medication needs of evacuees than their chronic medication demands. The DMAT pharmacy dispensed fewer doses per prescription

References (23)

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  • Cited by (80)

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    The full text of this article is available via AJPM Online at www.ajpm-online.net; 1 unit of Category-1 CME credit is also available.

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