Pharmacy disaster preparedness ‘poor to moderate’

Less than 18% of registered pharmacists were found to be prepared to respond to disasters such as bioterrorism in one study, Qld researchers discovered in literature review

Researchers from the School of Clinical Sciences at the Queensland University of Technology have conducted a systematic literature review to explore pharmacists’ and pharmacy students’ preparedness for disasters.

Disasters are increasing in intensity and frequency around the world, said researchers Elizabeth McCourt, Judith Singleton, Vivienne Tippett and Lisa Nissen.

“The 2019–2020 bushfire disaster in Australia, and the global COVID‐19 pandemic have highlighted the importance of health professionals being prepared for disasters,” they said.

“In order to prevent disruptions to the essential services provided by pharmacists during disasters, it is important that pharmacists across all practice settings are prepared.”

Following an extensive literature search, only four articles met inclusion criteria and exceeded the quality threshold. Three articles focused on pharmacy students’ preparedness for disasters, and one was on registered pharmacists’ preparedness.

In the first study, published in 2016, second‐year pharmacy students were divided into groups during a workshop and responded to one of three hypothetical infectious disease scenarios—anthrax, pandemic influenza and smallpox. Before the workshop, students had a mean preparedness score of 3.3, on a Likert scale from 0 (unprepared) to 10 (prepared). After the workshop this score increased to 4.1.

The second study from 2010 examined the preparedness of multiple health professions to respond to a bioterrorism event using a survey. Participants were required to self‐assess their competence. The final model found that 82.6% (n = 360 out of 436) of pharmacist participants included in the survey were not prepared for a bioterrorism attack. “Pharmacists seemed to be less prepared than physicians and nurses,” the original authors concluded.

Two further studies, both published in March 2020, examined the preparedness of multiple health professional students. Participants were required to self‐assess their perceived knowledge, attitude and readiness to practise.

The survey covered three components: knowledge of disasters and disaster medicine (K); attitude towards disasters and disaster medicine (A), and; readiness to practise in a disaster (rP). Pharmacy students in the first study scored a mean KArP score of 90 out of a potential 157 points (57%), while those in the second study scored a mean KArP score of 101 out of a potential 157 points (64%).

“Despite repeated calls for improved preparedness, there is little literature examining the pharmacy professions’ preparedness and the literature that does exist is methodologically limited,” the QUT research team found.

They said that while the pharmacy professions’ preparedness appears to be low, the factors that may influence preparedness may include:

  1. Disaster preparedness interventions – through education, training and drills. The 2010 study determined that previous involvement in disaster training (P< 0.001) and disaster drills (P < 0.001) were significant predictors of overall preparedness. If a health professional had participated in previous drills or training, they were 2.56 and 2.86 times more likely to be prepared for a bioterrorism attack respectively.
  2. Clinical and administrative competency – The studies also found that preparedness is directly correlated with perceived competency to fulfil roles in a bioterrorist event. Perceived competency may impact an individual pharmacists’ disaster preparedness.
  3. Willingness to respond – In one of the studies, participants’ willingness to respond was reported by the size of the bioterrorist incident (local, regional, state‐wide or nation‐wide impacts), and the perceived risk of the event (high or low risk). When compared to physicians and nurses, pharmacists were the least likely health professional to respond to a bioterrorist event. The proportion of pharmacists that were willing to respond to bioterrorist events varied between 44.5% for a low risk and nation‐wide event, to 80.7% for a low risk and local event.
  4. Demographic factors – Modelling in the 2010 paper found that gender (p = 0.042), city type (p = 0.020), current position (p = 0.033) and primary workplace type (p = 0.005) were significant predictors of overall preparedness. Pharmacists were significantly less prepared for bioterrorist attacks when compared with nurses and physicians (p < 0.001). Approximately 35% of the physician and nurse workforce surveyed were prepared for a disaster compared with <18% of pharmacists.

More robust research is needed, the researchers concluded. “For pharmacists, the lack of research around their preparedness speaks volumes about their current involvement and expectations within disaster management.”

Small sample sizes in the review, as well as the diversity in research methodology, made it difficult to draw robust conclusions about the differences in pharmacist and pharmacy student preparedness, they added.

“However, the consistency in poor preparedness across pharmacy students and pharmacists could indicate gaps in preparedness supports for both these groups,” they said. “Whilst health professionals such as physicians and nurses may have access to disaster education, training, or drills, there appears to be a lack of these interventions targeted at the pharmacy profession.”

The study was published in the International Journal of Pharmacy Practice

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1 Comment

  1. Kay Dunkley

    In Australia the division of state and federal responsibilities in disaster management create a lot of problems for the involvement of both GPs and community pharmacists. In addition the armed services bring in their own health professionals and logistics coordinators. We saw in the bushfires bypassing of local GPs and pharmacists and establishment of health centres by the state disaster management coordinators. So as well as preparedness there needs to be better coordination and use of existing services.

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