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Emergency supply kits (ESKs) may support disaster-related self-sufficiency and may be important for people with chronic health conditions (CHCs). However, evidence of ESK’s effectiveness in supporting self-sufficiency is lacking. This study examined associations between households possessing ESKs and 1) household members leaving home for medicine and 2) individuals with CHCs seeking medical care.
Methods
Data were collected through a survey distributed to southwest Florida after Hurricane Ian’s impact (n = 1342). Associations were assessed using logistic regression models.
Results
ESK possession was more common among households with members with CHCs (63%) than households without such members (56%). Overall, regression models revealed no clear association between ESK possession and leaving home for medicine (adjusted Odds Ratio (aOR)=1.27; CI = 0.81-2.02). Analyses restricted to households with individuals with CHCs revealed no clear associations between ESK possession and leaving the home for medicine (aOR= 1.35; CI = 0.81-2.25) or seeking medical care (aOR = 1.07; CI = 0.68-1.68).
Conclusions
This study did not provide evidence that ESKs promote medical self-sufficiency. However, it did not characterize the medication in households’ ESKs or the type, duration, and severity of CHCs, and could have had uncontrolled confounding. Characterization of such factors would be important in future studies of ESKs and self-sufficiency among people with CHCs.
The European General Practitioners Research Network (EGPRN) designed and validated a comprehensive definition of multimorbidity using a systematic literature review and qualitative research throughout Europe. Identification of risk factors for decompensation would be an interesting challenge for family physicians (FPs) in the management of multimorbid patients. The aim was to assess which items from the EGPRN’s definition of multimorbidity could identify outpatients at risk of decompensation at 24 months.
Methods:
A cohort study. About 120 multimorbid patients from Western Brittany, France, were included by general practitioners between 2014 and 2015. The status “decompensation” (hospitalization of at least 7 days or death) or “nothing to report (NTR)” was collected at 24 months of follow-up.
Findings:
At 24 months, there were 44 patients (36.6%) in the decompensation group. Two variables were significant risk factors for decompensation: the number of visits to the FP per year (HR = 1.06 [95% CI 1.03–1.10], P < 0.001) and the total number of diseases (HR = 1.12 [95% CI 1.013–1.33], P = 0.039).
Conclusion:
FPs should be warned that a high number of consultations and a high total number of diseases may predict death or hospitalization. These results need to be confirmed by large-scale cohorts in primary care.
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.
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