The Pharmaceutical Journal
Vol 270 No 7233 p132
25 January 2003

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American Society of Health-system Pharmacists summary

Pharmacists are multiskilled and can deal with crises

A disaster, whether a hurricane, aeroplane crash or terrorist attack, is a local event, said Commander Matthew Tarosky, pharmacy consultant for the Department of Health and Human Services Office of Emergency Response.

In an emergency situation local response agencies, including law enforcement, fire, hazardous materials, emergency management, public health and area medical and mental health services, must be integrated to be effective, he said. Pharmacists are an essential component in local emergency preparedness and can be extremely helpful in disaster-response planning. "Pharmacists are multitasked individuals and are used to dealing with crises," he said.

Pharmacists can provide expert advice about the appropriate use, storage and control of medicines and help to educate consumers and other health care practitioners about the adverse events associated with drug therapies. Pharmacists can also contribute to disease surveillance by alerting public health agencies to a potential health crisis in a community when the number of prescriptions for anti-infective medicines increases, he suggested. Collaboration between pharmacists and epidemiologists is important here. Lastly, pharmacists can use their skills to operate a mass distribution site for prophylactic medicines.

The pharmacist's knowledge of drug interactions and ability to recognise adverse drug events is essential during a mass distribution of prophylactic medications, according to Robert DiGregorio, pharmacy and emergency services clinical co-ordinator for Brookdale University Hospital and Medical Centre in Brooklyn, New York. Dr DiGregorio is also the chief pharmacists for New York City's Disaster Medical Assistance Team (DMAT) and serves on the city's Office of Emergency Management's bioterrorism response committee.

Recent studies had shown that thousands of people did not adhere to the prophylaxis regimens last year after the anthrax attacks in the United States. One reason for this was that many primary care physicians did not understand that the anti-infectives dispensed were for prevention and not treatment. The physicians had instructed their patients to stop taking the medicines, he explained.

After the formal presentations there was a simulation of the set-up and operation of a point of distribution site (POD) to treat members of the audience "exposed" to anthrax. Pharmacists staffing the POD took medical histories, assessed special needs, dispensed medication, and provided counselling for "symptomatic" patients. More than 150 attendees were processed in 15 minutes. The exercise scenario demonstrated the intricacies and challenges involved in distributing a large quantity of medicine to a large number of people in a short time. Local and national television teams were there to record the event.