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The Forgotten Patients in Cyclones: The Continuation of Opioid Replacement Therapy Program

Published online by Cambridge University Press:  06 May 2019

Niamh O’Dwyer
Affiliation:
School of Clinical Sciences, Queensland University Of Technology, Brisbane, Australia
Harrison Cliffe
Affiliation:
School of Clinical Sciences, Queensland University Of Technology, Brisbane, Australia
Kaitlyn E. Watson
Affiliation:
School of Clinical Sciences, Queensland University Of Technology, Brisbane, Australia
Elizabeth McCourt
Affiliation:
School of Clinical Sciences, Queensland University Of Technology, Brisbane, Australia
Judith A. Singleton
Affiliation:
School of Clinical Sciences, Queensland University Of Technology, Brisbane, Australia
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Abstract

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Introduction:

Cyclones are expected to increase in frequency and intensity, significantly impacting communities and healthcare services. During these times, those with chronic diseases such as opioid dependence are at an increased risk of disease exacerbation due to treatment regimen interruptions. Disruptions to the continuity of the opioid replacement therapy (ORT) service can be detrimental to both clients and the community which can potentially lead to relapse, withdrawal, and risky behaviors.

Aim:

To explore the impacts of cyclones on opioid treatment programs within community and hospital pharmacies in Queensland.

Methods:

Qualitative research methods were used in this study with two methods of data analysis employed: the text analytics software, Leximancer®, and manual coding. Interviews were conducted with five hospital and five community pharmacists and four Queensland opioid treatment program (QOTP) employees. Participants worked in Mackay, Rockhampton, Townsville, and Yeppoon in a community impacted by a cyclone and involved with ORT supply.

Results:

The themes developed in the manual coding were “impact on essential services,” “human experience,” “healthcare infrastructure,” “preparedness,” and “interprofessional networks.” These themes were aligned with those identified in the Leximancer® analysis. The community pharmacists focused on client stability, whereas, the hospital pharmacists and QOTP employees focused on the need for disaster plans to be implemented.

Discussion:

The greatest concern for participants was maintaining the stability of their clients. Communication amongst the dosing sites and ORT stakeholders was most concerning. This led to a lack of dosing information in a timely manner with pharmacists being hesitant to provide doses and takeaways due to legislative restrictions. A review of coordinated efforts and the legislative constraints is recommended to ensure continuity of ORT supply during cyclones.

Type
Osteopathic Medicine
Copyright
© World Association for Disaster and Emergency Medicine 2019