Disparity in disaster preparedness among rheumatoid arthritis patients with various general health, functional, and disability conditions

Abstract

Objectives To describe disaster preparedness among chronically ill patients and to examine how differences in health, functional, and disability conditions are associated with disaster preparedness, focusing on rheumatoid arthritis (RA) patients with various functional and disability levels. Methods In 2007, 1,477 members of a nationwide RA patient group in Japan who lived in municipalities affected by natural disasters between 2004 and 2006 were asked to participate in a questionnaire survey. Three medical preparedness indicators, namely, medication stockpiles, the carrying of medications, and the carrying of prescription/ treatment records, and three general preparedness indicators, namely, having emergency packs, emergency communication plans, and emergency evacuation plans, were used as dependent variables. Multivariable logistic models were applied to examine the associations of health-related vulnerability variables with the preparedness variables. Results Of the 553 subjects included into the analysis, only one-half had taken medical preparedness measures and only one-quarter had taken general preparedness measures. Although physical disability and poorer functional level were associated positively with the medical preparedness, those with poorer perceived health were less likely to carry medications and prescription/treatment records, and those receiving the highest long-term care levels were less likely to carry medications than their healthier counterparts.Conclusions Among the population of chronically ill RA patients surveyed, disaster preparedness was insufficient, and their preparedness status varied with health, functional, and disability conditions. We suggest that policy-makers should give careful thought to the targets they set for disaster preparedness.

Emergency and disaster preparedness for chronically ill patients: a review of recommendations

“…Disparities in preparedness status have been found in a variety of situations, presumably because of patient characteristics, including educational level, financial status, the presence of caregivers, and the awareness of disaster risk. 61 , 69 – 74 Thus, effective and culturally relevant communications regarding health risks with disasters are crucial to improving preparedness levels, especially among these vulnerable populations. 58 , 70 To provide more feasible preparedness recommendations, a balanced combination of patient and health care provider preparedness is required in the presence of collaboration efforts by governmental and nongovernmental organizations.…”

Health-Related Quality of Life Domains and Household Preparedness for Public Health Emergencies: Behavioral Risk Factor Surveillance System, 2006-2010

“…Finally, in a group of adults with rheumatoid arthritis in Japan, those with poorer perceived health were less likely than those with more favorable perceived health to carry medications and prescription and treatment records. 9 It is notable that a variety of impaired physical and mental quality of life outcomes have been associated with detrimental behaviors of omission. In a study of older adults with hypertension in a managed care organization conducted by Holt et al, 10 people with low mental or physical quality of life scores were less likely than those with higher scores to take prescribed antihypertensive medication.…”

Earthquake Preparedness Among Japanese Hemodialysis Patients in Prefectures Heavily Damaged by the 2011 Great East Japan Earthquake

“…On the previous experience of disasters, some studies have shown that previous disaster exposure is highly associated with the degree of disaster preparedness in the general population . In terms of medically vulnerable populations, the previous experience of disasters has had a limited effect on disaster preparedness in rheumatoid arthritis patients though . In this study, only education had a significant influence on higher levels of earthquake preparedness among the range of demographic and socioeconomic factors, including previous experience of disasters.…”

“…The characteristics of patients who are involved in this patient group may differ in respect of age, sex, cause of renal diseases, and duration of dialysis in comparison with all dialysis patients . It is further pointed out that the members of a specific patient group might have better disaster preparedness status than the general population of RA subjects . As total‐group results might be worse than those presented here, this study is limited in terms of external validity and its ability to be generalized to other areas and non‐members of this patient group in Japan.…”

“…Comparison of our results with these results seems to show that the levels of disaster preparedness among hemodialysis patients are relatively low, not only in the US but also in Japan, although our two studies used different scales for disaster preparedness. Studies for medically vulnerable groups, such as rheumatoid arthritis patients and the families of individuals with severe and intellectual disabilities indicate that their compliance rates with some items of disaster preparedness are relatively low. Thus, it is easy to guess that levels of disaster preparedness are relatively low even in populations with medically vulnerable conditions, including dialysis.…”