Hostname: page-component-669899f699-swprf Total loading time: 0 Render date: 2025-04-25T23:41:03.958Z Has data issue: false hasContentIssue false
  • English
  • Français

Interruption of Medication among Outpatients with Chronic Conditions after a Flood

Published online by Cambridge University Press:  28 June 2012

Jun Tomio ,
Hajime Sato  and
Hairoko Mizumura
Jun Tomio
Affiliation:
Department of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan Department of Preventive Medicine, St. Marianna University School of Medicine, Kanagawa, Japan
Hajime Sato*
Affiliation:
Department of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
Hairoko Mizumura
Affiliation:
Department of Preventive Medicine, St. Marianna University School of Medicine, Kanagawa, Japan Department of Human Environment Design, Faculty of Human Life Design, Toyo University, Saitama, Japan
*
Department of Public HealthGraduate School of MedicineThe University of Tokyo7-3-1 Bunkyo-ku, Tokyo 1130033, Japan E-mail: hsato-tky@umin.ac.jp
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction:

The disruption of routine treatment, including the interruption of medication, exacerbates chronic conditions during disasters. However, the health consequences of the interruption of medication have not been fully examined. On 22 July 2006, a flash flood affected more than 3,000 households in five cities and four towns in the northern part of Kagoshima Prefecture in southwest Japan. The aims of this study are to describe the prevalence of the interruption of medication among the outpatients in the flood-affected area and to determine the risk and preventive factors for the interruption of medication.

Methods:

This was a cross-sectional study using a self-administered questionnaire. The study subjects were the outpatients who visited nine of 15 medical facilities in the flood-affected area from 23 January and 31 January 2007. Of 810 valid respondents, 309 who received medication treatment before the event were eligible for the study. Information on socio-demographic factors, chronic health conditions, preparedness-related factors before the event and damage-related factors were collected. Overall and evacuation status-specific prevalence of interruption of medication were presented. For those evacuated, the associations between interruption of medication and relevant patient characteristics, as well as deterioration of health status after the event, were examined.

Results:

The prevalence of interruption of medication was 9% in total, but it increased up to 23% among the evacuated subjects. Interruption of medication was more likely among those aged ≥75 years (odds ratio [OR] = 3.6; 95% confidence interval [CI] = 1.0−12.6) and those receiving long-term care services (OR = 4.6; 95% CI = 1.1−19.1), while it was less likely among those with hypertension (OR = 0.2; 95% CI = 0.1−0.8) and those prepared to go out with medication (OR = 0.2; 95% CI = 0.03−0.8). Those who experienced interruption of medication were more likely to have deteriorated health status one month after the event (OR = 4.5; 95% CI = 1.2−17.6).

Conclusions:

Interruption of medication occurred more commonly among the evacuated subjects. Among the evacuated, the elderly and those receiving longterm care services were at high risk for interruption of medication, while the preparedness behavior of “preparing to go out with medication” had preventive effect. Special attention must be paid to the high-risk subgroups, and some preventive behaviors should be recommended.

Keywords

chronic conditiondisaster preparednessfloodinterruption of servicesoutpatient
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 25 , Issue 1 , February 2010 , pp. 42 - 50
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

1.Mokdad, AH, Mensah, GA, Posner, SF, et al. : When chronic conditions become acute: Prevention and control of chronic diseases and adverse health outcomes during natural disasters. Prev Chronic Dis 2005;2(Special Issue):A04.Google ScholarPubMed
2.Krousel-Wood, MA, Islam, T, Muntner, P, et al. : Medication adherence in older clinic patients with hypertension after Hurricane Katrina: Implications for clinical practice and disaster management. Am J Med Sci 2008;336(2):99–104.Google Scholar
3.Kario, K, Matsuo, T, Kobayashi, H, et al. : Earthquake-induced potentiation of acute risk factors in hypertensive elderly patients: Possible triggering of cardiovascular events after a major earthquake. J Am Coll Cardiol 1997;29(5):926–933.Google Scholar
4.Inui, A, Kitaoka, H, Majima, M, et al. : Effect of the Kobe earthquake on stress and glycemic control in patients with diabetes mellitus. Arch Intern Med 1998;158(3):274–278.CrossRefGoogle ScholarPubMed
5.Kamoi, K, Tanaka, M, Ikarashi, T, et al. : Effect of the 2004 Mid Niigata Prefecture earthquake on glycemic control in type 1 diabetic patients. Diabetes Res Clin Pract 2006;74(2):141–147.Google Scholar
6.Kirizuka, K, Nishizaki, H, Kohriyama, K, et al. : Influences of The Great Hanshin-Awaji Earthquake on glycemic control in diabetic patients. Diabetes Res ClinPract 1997;36(3):193–196.CrossRefGoogle ScholarPubMed
7.Kessler, RC: Hurricane Katrina's impact on the care of survivors with chronic medical conditions. J Gen Intern Med 2007;22(9):1225–1230.Google Scholar
8.Brodie, M, Weltzien, E, Altman, D, et al. : Experiences of Hurricane Katrina evacuees in Houston shelters: Implications for future planning. Am J Public Health 2006;96(8):1402–1408.Google Scholar
9.Ford, ES, Mokdad, AH, Link, MW, et al. : Chronic disease in health emergencies: In the eye of the hurricane. Prev Chronic Dis 2006;3(2):A46.Google ScholarPubMed
10.Cefalu, WT, Smith, SR, Blonde, L, et al. : The Hurricane Katrina aftermath and its impact on diabetes care: observations from “ground zero”: Lessons in disaster preparedness of people with diabetes. Diabetes Care 2006;29(1):158–160.Google Scholar
11.Greenough, PG, Lappi, MD, Hsu, EB, et al. : Burden of disease and health status among Hurricane Katrina-displaced persons in shelters: A population-based cluster sample. Ann Emerg Med 2008;51:426–432.Google Scholar
12.Kagoshima Prefecture: North Kagoshima Prefecture heavy rainfall disaster in July 2006: Summary of the damages and record of the responses. Available at http://www.pref.kagoshima.jp/bosai/saigai/h1807/index.html. Accessed 17 November 2008.Google Scholar
13.Statistics Bureau, Director-General for Policy Planning (Statistical Standards), and Statistical Research and Training Institute: Information on the 2005 population Census of Japan. Available at http://www.stat.go.jp/english/data/kokusei/index.htm. Accessed 16 April 2009.Google Scholar
14.Okumura, J, Nishita, Y, Kimura, K: Pharmaceutical supply for disaster victims who need chronic disease management in region with aging population based on lessons learned from the Noto Peninsula Earthquake in 2007. Yakugaku Zasshi 2008;128(9):1275–1283.Google Scholar
15.Fernandez, LS, Byard, D, Lin, CC, et al. : Frail elderly as disaster victims: emergency management strategies. Prehosp Disaster Med 2002;17(2):67–74.Google Scholar
16.General Affairs Division, Health and Welfare Bureau For the Elderly, the Ministry of Health, Labour and Welfare: Long-term Care Insurance in Japan. Available at http://www-bm.mhlw.go.jp/english/topics/elderly/care/index.html. Accessed 18 November 2008.Google Scholar
17.Policy Planning Division, Department of Health and Welfare for Persons with Disabilities, Social Welfare and War Victims' Relief Bureau, the Ministry of Health, Labour and Welfare: Report of the survey on the actual status of physically disabled persons and children in 2006. Available at http://www.mhlw.go.jp/toukei/saikin/hw/shintai/06/dl/01.pdf. Accessed 17 November 2008.Google Scholar
18.Investigative commission for the evacuation strategy for the people with special needs to disaster: Guidelines for the evacuation support for the people with special needs to disaster. Available at http://www.bousai.go.jp/hinan_kentou/060328/hinanguide.pdf. Accessed 18 November 2008.Google Scholar