How prepared are you for disaster and emergency?

Flooding in Lismore. Source: NSW Flood Update, Facebook.

The story of a pharmacist on the frontline during an Ebola outbreak inspired another to start researching the profession’s role in disasters

Pharmacists are underutilised in disaster planning and response, says Queensland pharmacist and PhD student Elizabeth McCourt, who is currently conducting research into the area. Part of the research includes a survey for pharmacists.

“Pharmacists are highly trained, skilled, and accessible and perfectly positioned throughout the healthcare system to contribute in a variety of ways after a disaster,” she told the AJP.

She says she attended a FIP Congress in Dusseldorf in 2015, and heard a pharmacist from West Africa speak about the way an outbreak of the Ebola virus had affected his community.

“He said that a lot of health professionals in his community left because the fear of Ebola was so great,” Ms McCourt says.

“He was one of the only health professionals remaining in his area. He stepped into a lot of different roles; taught people how to make cleaning products, drove his delivery van around dispelling Ebola myths by shouting through a microphone, and providing ongoing healthcare to the community without the usual doctors or nurses to support him.

“I know that our health systems are extremely different, but it really inspired me to think about how vital pharmacists can be during a crisis. I came back to Australia and was keen to start on some research in the area.

“I was very fortunate that that two of my mentors from my undergraduate degree, Prof Lisa Nissen and Judith Singleton, were also interested in this space and had already accepted another PhD Candidate, Kaitlyn Porter, to start researching in this area. So I joined the team too.”

Ms McCourt’s survey is investigating pharmacist preparedness for disasters and emergencies, with an aim of developing recommendations for pharmacists’ role in these events.

This role needs greater recognition and support, she says, at a formal level.

“I know there are many pharmacists who work tirelessly when disasters affect their local communities, but we need all levels of government in Australia and all areas of the pharmacy workforce to realise the important contribution pharmacists can make,” she says.

“I believe one of the key issues with pharmacists being more utilised in disasters is a lack of disaster planners’ engagement with the profession. I believe pharmacists and professional pharmacy organisations need to advocate what pharmacists can do in the aftermath of a disaster in order to start bridging that gap.”

There is a gap in education and training, including CPD activities, for pharmacists about preparing for disasters, Ms McCourt says; she has had a number of discussions with pharmacists who feel that the professional organisations have a role to play in providing it, and she hopes that the survey will help quantify what support pharmacists currently receive, and where they feel they can be better supported.

As it stands, one of the biggest impacts on patients’ health following a disaster is lack of access to regularly taken medicines treating chronic disease states.

“People might lose medications or prescriptions in the disaster or forget them while being evacuated,” Ms McCourt says.

“If people with chronic diseases miss medications it can result in disease exacerbations, complications, hospitalisations, or even death in extreme circumstances.

“Ensuring that people have access to their regular medications is something that pharmacists can already do, but there is definitely room for improvement. For example across Australia the majority of States and Territories only allow pharmacists to supply three days of emergency medications to people, the Northern Territory allows seven.

“If there was legislation in place to support supply for a longer period of time (to allow for the community and infrastructure to recover), I think this would make a huge impact on individuals and the health system.”

A key area of concern is how poorly pharmacists are involved in pandemic influenza planning and response in Australia, Ms McCourt says.

“I would like to see policy and legislation changed to support pharmacists in contributing more during a pandemic,” she says, highlighting an article she recently published on the subject.

“An example of this might be through supply of longer ‘absence from work’ certificates or allowing pharmacists to be able to vaccinate outside their pharmacy walls so that they can contribute by working in mass vaccination clinics that might be opened in a pandemic.”

Ultimately, she hopes that pharmacists in all sectors – community, hospital or GP practice – would be supported to look after members of their community to the best of their skills and abilities in the aftermath of a disaster.

“There is definitely a lot we can learn from other countries about enhanced roles in disasters. In Japan in the aftermath of a disaster, pharmacists often work in evacuation centres interviewing patients,” she says.

“They find out the medications they were on (often by descriptions of bottles and tablet shape), write the list out and discuss it with a doctor.

“After discussion the pharmacist is then able to supply a month of those medications or can substitute medications not available for those that are therapeutically equivalent.

“I think Australian pharmacists working within or in liaison with evacuation centres could do a lot of good for patients and broader health systems. It is something I would be interested to see developed.”

Pharmacists and interns can take part in the research here. The survey remains open until 31 May 2018.

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