Author: Kate Baggaley
Hurricane Ian made landfall on the Florida peninsula as a category 4 hurricane near Cayo Costa. Georgia and South Carolina have also been issued storm surge and tropical storm alerts.
Two experts shared some steps that pharmacies in areas likely to be affected by the storm can take to prepare, and important information that pharmacists should convey to patients.
“Know your threats and your resources,” advised Brenda Gray, PharmD, VA-BC, CNSC, BCNSP, PRS, CVAA(c), an owner and senior clinical consultant at Clinical Pharmacy Partners, in Tampa, Fla. “You can never plan for every event, but you can know your tools and use that to guide decisions.”
Ahead of any weather event, ensuring patients have their medications should be top-of-mind for any pharmacist, said Tracey James, RPh, the chief operating officer at AllianceRx Walgreens Prime. “Pharmacists can also answer any questions patients may have about how to store their medicine in unique situations,” she said.
Steps for Pharmacists
Dr. Gray, who gave a presentation on disaster planning last week at the National Association of Specialty Pharmacy 2022 Annual Meeting & Expo, in Orlando, Fla., recommended the following steps for pharmacists:
• Determine how much of a threat your area faces from wind or flooding; this will affect the kind of damage your pharmacy may sustain.
• Put important numbers, such as your local board of pharmacy and wholesaler, in your phone; don’t depend on the internet. If your building is damaged, Dr. Gray said, you’ll need this information to set up an alternate location.
• Check with delivery partners to find out where supplies can and cannot be sent.
• Know who your partners are in affected areas who may be able to help with patients, if needed.
• Check with patients in affected areas regarding evacuation plans.
• Most importantly, remind all patients to never place themselves in danger to access medication or to use damaged medication, and instead to call their pharmacy for assistance.
It’s also important to avoid overloading emergency rooms and 911 call centers.
“Only a few specialty meds can’t have a small gap in therapy or flexible scheduling,” Dr. Gray said. “[Pulmonary arterial hypertension] and transplant [medications] are common exceptions, [so] make sure these patients have a safe plan.”
When the storm has passed and roads have reopened, check your building for damage before allowing employees to come in. Have a process in place to handle calls from your usual patients and those who have been displaced into your area, Dr. Gray added.
After the hurricane, Ms. James said, “we reach out again to patients to determine if they have moved to a new location, so we can make sure they receive [their medications].”
She agreed that it’s important to be proactive in following up with patients in potentially affected areas ahead of a weather emergency via phone, text and email to mitigate risk and delays in therapy, and to make sure patients understand any potential side effects or consequences of missed doses.
“Pharmacists are helpful in making sure patients have any support resources they may need, whether pertaining to their medication or to the disaster at hand (i.e., Red Cross, etc.),” Ms. James said. “Pharmacists also help coordinate in the event an emergency fill is necessary to meet the patient’s clinical needs.”
Her organization also does the following to prepare:
• proactively works with patients’ insurance companies to fill prescriptions early and deliver them so patients will have them before the hurricane;
• works with insurance companies to obtain overrides to have patients’ medications filled at a local store if they’re unable to ship; and
• schedules delivery for potentially involved locations ahead of the storm and partners with their shipping carriers to confirm shipping for patients.
“We have relationships with FedEx or other couriers. Because ours are lifesaving medications, we get the highest priority over something from a catalog, for instance,” Ms. James added. “We have facilities that perform similar tasks and can shift work as needed to meet the needs of our patients at any time, in any circumstance.”
Information for Patients
Dr. Gray also recommended several key points to convey to patients:
• Take medications if you can when you evacuate.
• In case of a power failure, check with your pharmacy regarding storage options for temperature-sensitive medications.
• Never use dry ice to refrigerate medications; use it to refreeze gel packs if needed.
• Shelters are crowded and have limited resources; bring hand sanitizer, masks and other supplies.
• If a boil-water notice indicates that the water in your area is not safe to drink, use sanitizer after you’ve washed your hands before handling medications (especially injectables).
Make sure patients understand that “meds can be replaced, but lives can’t,” Dr. Gray said. “Don’t leave meds behind, but if you find yourself in crisis, don’t risk [your] life for meds.”
Ms. James said her organization encourages patients to do the following:
• Always have a seven-day supply of their prescription medications.
• Work with their doctor to get a copy of their prescriptions.
• Talk with their pharmacist about how to store their medications.
• Call to report if they’ll be at a temporary location so the pharmacy can send medication to the right place.
Preparing for Future Disasters
Once your pharmacy is able to resume normal operations, it’s time to debrief.
“Ask what you know now you wish you knew before. Ask what works and does not work,” Dr. Gray said. “Don’t just ask management, but all staff. Use this to improve [your] plan.”
She also recommended enlisting a third party to run disaster drills or run debriefing sessions. “I do this for a lot of companies each year, and often we find things that have never come up when done internally because assumptions get made,” Dr. Gray said.
Ms. James said it’s a good idea for patients to have an emergency medication kit ready for future hurricanes and other disasters that contains:
• their prescription medications (including prescription eyeglasses);
• medical devices and supplies;
• nonprescription medications such as pain relievers and antacids; and
• a list of current prescriptions and over-the-counter medications.
“We are available 24/7 throughout any storm or natural disaster,” Ms. James said. “We offer valuable information and educational content to help answer any questions patients may have about their prescriptions or how to order them online.”
Additionally, the healthcare company Henry Schein released a press release reminding customers in the path of Hurricane Ian that its customer assistance hotline is available for dentists and physicians who experience difficulties related to storm damage.
In the statement, Stanley M. Bergman, the chair and CEO, said, “Team Schein is ready to help our customers whose practices may be damaged or otherwise affected by the storm, and healthcare professionals are encouraged to contact our hotline for assistance with recovery and rebuilding efforts.”