Primary care in disasters: opportunity to address a hidden burden of health care

Burns, Penelope; Douglas, Kirsty; Hu, Wendy

doi:10.5694/mja2.50067

Cited by 19 publications

(23 citation statements)

References 8 publications

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“…Much of the stresses on community pharmacists during these events could be reduced if primary care practitioners (GPs and pharmacists) were included in disaster management planning and in communication channels prior to, and during, disasters. This corroborates the findings of a previous study on the impacts to community pharmacy services of the Tasmanian 2012/2013 summer bushfires, 19 as well as the findings of Burns, et al 24 who argued for improved incorporation of primary care in disaster management planning. Research has also highlighted that pharmacists are able to fulfil a number of roles during disasters 12,25 and would most likely report to work during a disaster because they believe their pharmacy provides an essential service to their community.…”

Section: Discussionsupporting

confidence: 91%

“…26 Following disasters, Australians will seek medical assistance from local GP practices, community pharmacies, and public hospitals. 24 Immediately following a disaster, both pharmacists 19 and GPs 24 have reported being inundated with patients seeking medical assistance or medication supplies. Pharmacists and GPs play an important role in helping the community in the recovery phase, which will continue long after first responders and the media have left.…”

Section: Discussionmentioning

confidence: 99%

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Still Burning: An Exploration of the Impacts of the 2018/2019 Tasmanian Summer Bushfires on Community Pharmacy Operations in Affected Communities

Singleton

Khng

McCourt

et al. 2020

Prehosp. Disaster med.

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Introduction: Human-induced climate change is increasing the likelihood and severity of wildfires across the globe. This has negative consequences for the health of affected communities through the loss of health systems’ infrastructure and disrupted health services. Community pharmacies are a central hub between patients and the health care system and can provide continuity of care during wildfires. However, there is little in peer-reviewed literature about the impacts of wildfires on community pharmacy operations. Study Objective: The aim of this study was therefore to explore the impacts of the 2018/2019 summer bushfires in Tasmania, Australia on community pharmacy operations in affected areas. Methods: Semi-structured telephone interviews were conducted with four community pharmacists who were working in the affected region during the bushfires. Interviews were audio recorded and transcribed verbatim. Qualitative data were analyzed using two methods– manual coding utilizing NVivo software and Leximancer analysis. Inter-rater reliability was ensured by two researchers analyzing the data independently. Differences in coding were discussed and agreement reached through negotiation amongst the research team. Results: From the manual coding analysis, five key themes emerged – communication and collaboration; support; patient health challenges; pharmacist experiences in delivering health care; and future planning. These aligned with the five themes that emerged from the Leximancer analysis – community; local; town; patients; and work. Participants described working during the wildfires as difficult, with multiple challenges reported including communication difficulties, operational barriers such as power cuts, legislative barriers, logistical issues with obtaining and storing medication supplies, and lack of preparation, support, and funding. They highlighted a lack of operational and financial support from the government and received most assistance from local council bodies and local branches of professional pharmacy organizations. Conclusion: During disasters, community pharmacies help reduce the burden on public hospitals by maintaining medication supplies and treating patients with minor ailments. However, increased support and inclusion in disaster management planning is needed to continue this role.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Still Burning: An Exploration of the Impacts of the 2018/2019 Tasmanian Summer Bushfires on Community Pharmacy Operations in Affected Communities

Singleton

Khng

McCourt

et al. 2020

Prehosp. Disaster med.

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“…International evidence has long proposed that health systems with a stronger primary care focus provide better health outcomes, 1,2 and the importance of Australian primary care in disaster management has been identified previously. 3 The strength of primary care is potentially one of the reasons for Australia's successful response to the COVID-19 pandemic to date.…”

Section: Introductionmentioning

confidence: 99%

General practice's early response to the COVID-19 pandemic

Wright¹,

Versteeg²,

Hall³

2020

Aust. Health Review

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The COVID-19 pandemic has resulted in multiple changes in the delivery of general practice services. In response to the threat of the pandemic and in order to keep their businesses safe and viable, general practices have rapidly moved to new models of care, embraced Medicare-funded telehealth and responded to uncertain availability of personal protective equipment with innovation. These changes have shown the adaptability of general practice, helped keep patients and practice staff safe, and undoubtedly reduced community transmission and mortality. The pandemic, and the response to it, has emphasised the potential dangers of existing fragmentation within the Australian health system, and is affecting the viability of general practice. These impacts on primary care highlight the need for improved integration of health services, should inform future pandemic planning, and guide the development of Australia’s long-term national health plan.

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“…Involving primary care clinicians in disaster management allows opportunity to evaluate evolving care needs and gain an improved understanding of the impact of displacement on the community. 16…”

Section: Far-reaching Volcanic Hazardsmentioning

confidence: 99%

Health Impacts of Volcanic Activity in Oceania

Cuthbertson

Stewart²,

Lyon

et al. 2020

Prehosp. Disaster med.

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Volcanoes cause a wide range of hazardous phenomena. Close to volcanic vents, hazards can be highly dangerous and destructive and include pyroclastic flows and surges, ballistic projectiles, lava flows, lahars, thick ashfalls, and gas and aerosol emissions. Direct health impacts include trauma, burns, and exacerbation of respiratory diseases. Far-reaching volcanic hazards include volcanic ashfalls, gas and aerosol dispersion, and lahars. Within Oceania, the island arc countries of Papua New Guinea (PNG), the Solomon Islands, Vanuatu, Tonga, and New Zealand are the most at-risk from volcanic activity. Since 1500ad, approximately 10,000 lives have been lost due to volcanic activity across Oceania, with 39 lives lost since 2000. While volcano monitoring and surveillance save lives, residual risks remain from small, sudden, unheralded eruptions, such as the December 9, 2019 eruption of Whakaari/White Island volcano, New Zealand which has a death toll of 21 at the time of writing. Widespread volcanic ashfalls can affect the habitability of downwind communities by contaminating water supplies, damaging crops and buildings, and degrading indoor and outdoor air quality, as well as disrupting transport and communication networks and access to health services. While the fatality rate due to volcanic eruptions may be low, far greater numbers of people may be affected by volcanic activity with approximately 100,000 people in PNG and Vanuatu displaced since 2000. It is challenging to manage health impacts for displaced people, particularly in low-income countries where events such as eruptions occur against a background of low, variable vaccination rates, high prevalence of infectious diseases, poor sanitation infrastructure, and poor nutritional status. As a case study, the 2017-2018 eruption of Ambae volcano, Vanuatu caused no casualties but triggered two separate mandatory off-island evacuations of the entire population of approximately 11,700 people. On the neighboring island of Santo, a health disaster response was coordinated by local government and provided acute care when evacuees arrived. Involving primary care clinicians in this setting enhanced local capacity for health care provision and allowed for an improved understanding of the impact of displacement on evacuee communities.

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Primary care in disasters: opportunity to address a hidden burden of health care

Cited by 19 publications

References 8 publications

Still Burning: An Exploration of the Impacts of the 2018/2019 Tasmanian Summer Bushfires on Community Pharmacy Operations in Affected Communities

Still Burning: An Exploration of the Impacts of the 2018/2019 Tasmanian Summer Bushfires on Community Pharmacy Operations in Affected Communities

General practice's early response to the COVID-19 pandemic

Health Impacts of Volcanic Activity in Oceania

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