Questionnaire survey on the continuity of home oxygen therapy after a disaster with power outages

Can Homecare Chronic Respiratory Disease Patients with Home Oxygen Treatment (HOT) in Southern Okinawa, Japan Be Evacuated Ahead of the Next Anticipated Tsunami?

An earthquake with a magnitude of 8 or 9 is predicted to occur near the Ryukyu Islands in Japan, for which the Okinawa Prefecture is preparing countermeasures. Evacuating people to a safe shelter within the tsunami arrival time is a crucial countermeasure. This study aims to understand the vulnerabilities of patients with chronic respiratory diseases in southern parts of Okinawa during a tsunami evacuation, thereby calculating evacuation distance of vulnerable patients and creating individual evacuation plans. Data for chronic respiratory patients obtained in July 2021 from the hospitals in Okinawa Prefecture include age, gender, diagnosis, residence, nearest tsunami shelter, oxygen flow at rest and walking, and maximum walking distance for 6 min based on a 6-min walk test. A quantum geographic information system was used for mapping the data. The survival potential of patients with chronic respiratory disease was evaluated by using a tsunami inundation depth of one meter and the distance within which an evacuation can be performed until the first tsunami wave reaches the nearest evacuation shelter. Results revealed a low survival potential for respiratory disease patients under the current tsunami evacuation plan. The study suggests creating an individual evacuation plan for vulnerable patients involving families and medical staff and then conducting a drill for improving the plan.

Development of a Home Health Patient Assessment Tool for Disaster Planning

BACKGROUND

Historically, older adults have been disproportionately affected by disasters. In particular, homebound adults are especially at risk. As one facet of bolstering community resilience, home health agencies have been tasked with improving their patients' disaster preparedness. However, home health practitioners often lack the information necessary to fulfill these requirements. Providing resources about disaster preparedness will allow these practitioners, often seen as trusted advisors, to better prepare their patients.

OBJECTIVE

This study explores the utility of implementing a checklist-style assessment tool to guide Veterans Health Administration (VHA) Home-Based Primary Care (HBPC) practitioners in disaster preparedness assessments of their patients.

METHODS

The HBPC Patient Assessment Tool for Disaster Planning ("Tool") was fielded by practitioners at 10 VHA HBPC programs with all patients seen over the course of a 3-week period. Descriptive statistics and bivariate analysis of the data collected via the Tool were used to understand the baseline levels of preparedness education provided by practitioners to their patients. Data from a follow-up survey and follow-up interviews with Program Managers were analyzed, the latter using content analysis methods.

RESULTS

754 surveys were returned for analysis. We examined how frequently practitioners reviewed the included preparedness items with their patients. Of those patients on oxygen, adherence ranged from 67 to 94% for practitioners covering a discussion about smoking materials/open flame, despite strong efforts to achieve high compliance on this measure as reported by several program managers. Of those items applicable to the general population, certain items were more frequently discussed than others. How to activate 911 services was most frequently reviewed (87%). Providing information about emergency shelter registration and specialty transport was the item least frequently reviewed (44%). Strengths about the Tool included its ease of use, flow, comprehensiveness, and that it fits on one page.

CONCLUSION

Home-based care programs, such as the VHA HBPC program, are tasked with supporting the emergency preparedness of their patients, but often do not have the expertise to do so. This study shows that the checklist-like structure of an assessment tool can assist with this role by encouraging practitioners to cover key points with patients and their caregivers.

Power Outage Preparedness and Concern among Vulnerable New York City Residents

Power outages can impact health, and certain populations may be more at risk. Personal preparedness may reduce impacts, but information on power outage preparedness and risk perception among vulnerable populations is limited. We examined power outage preparedness and concern among New York City residents, including vulnerable populations defined as older adults (≥ 65 years), and respondents with household members who require assistance with daily activities or depend on electric medical devices. A random sample telephone survey was conducted during November-December 2016. Preparedness was defined as having a three-day supply of drinking water, non-perishable food, and a working flashlight. Among all respondents (n = 887), 58% were prepared and 46% expressed concern about health. Respondents with electric-dependent household members (9% of all respondents) tended to have higher preparedness (70 vs. 56% of respondents without electric-dependent household members). Among this group, only 40% reported being registered with a utility company to receive early notification of outages. While the subgroup sample was small, respondents with registered electric-dependent household members had lower preparedness than those with non-registered users (59 vs. 76%). Respondents with household members who needed assistance had comparable levels of preparedness to respondents without someone who needed assistance (59 vs. 57%). Older adults had greater preparedness than younger adults (65 vs. 56%). Health concerns were greater among all vulnerable groups than the general population. Levels of preparedness varied among vulnerable respondents, and awareness of power outage notification programs was low. Our findings highlight the need to increase awareness and preparedness among at-risk people.

Noncommunicable Diseases After the Great East Japan Earthquake: Systematic Review, 2011-2016

OBJECTIVE

Noncommunicable diseases (NCDs), including mental disorders, have become major threats to human health worldwide. People with NCDs are particularly vulnerable to disasters. We systematically reviewed reports describing studies of NCDs at the time of the Great East Japan Earthquake (GEJE) to clarify the circumstances of people with NCDs and to build strong measures to support them.

METHODS

Relevant articles published from March 2011 through December 2016 were collected by searching the PubMed database (National Library of Medicine). We specifically examined reports describing NCDs and including the key words "East Japan Earthquake." NCDs included every disease type aside from injury and infectious disease.

RESULTS

We collected 160 relevant articles, 41 of which described NCDs that existed in residents before the GEJE. Articles describing respiratory diseases and mental illnesses were found most frequently. Interruption of regular treatment was the most frequent problem, followed by lack of surveillance capacity. We found 101 reports describing NCDs that had developed after the GEJE, of which 60% were related to mental health issues.

CONCLUSIONS

NCDs pose major health issues after large-scale disasters. Establishment of strong countermeasures against interruption of treatment and surveillance systems to ascertain medical needs for NCDs are necessary to prepare for future disasters. (Disaster Med Public Health Preparedness. 2018; 12: 396-407).

Disaster-driven evacuation and medication loss: a systematic literature review

AIM

The aim of this systematic literature review was to identify the extent and implications of medication loss and the burden of prescription refill on medical relief teams following extreme weather events and other natural hazards.

METHOD

The search strategy followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Key health journal databases (Medline, Embase, PsycINFO, Maternity and Infant Care, and Health Management Information Consortium (HMIC)) were searched via the OvidSP search engine. Search terms were identified by consulting MeSH terms. The inclusion criteria comprised articles published from January 2003 to August 2013, written in English and containing an abstract. The exclusion criteria included abstracts for conferences or dissertations, book chapters and articles written in a language other than English. A total of 70 articles which fulfilled the inclusion criteria were included in this systematic review.

RESULTS

All relevant information was collated regarding medication loss, prescription loss and refills, and medical aids loss which indicated a significant burden on the medical relief teams. Data also showed the difficulty in filling prescriptions due to lack of information from the evacuees. People with chronic conditions are most at risk when their medication is not available. This systematic review also showed that medical aids such as eye glasses, hearing aids as well as dental treatment are a high necessity among evacuees.

DISCUSSION

This systematic review revealed that a considerable number of patients lose their medication during evacuation, many lose essential medical aids such as insulin pens and many do not bring prescriptions with them when evacuated.. Since medication loss is partly a responsibility of evacuees, understanding the impact of medication loss may lead to raising awareness and better preparations among the patients and health care professionals. People who are not prepared could have worse outcomes and many risk dying when their medication is not available.