scholarly journals Multimorbidity Network Surveillance: Chronic Disease Clusters and Social Disparities

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Eun Kyong Shin ◽  
Youngsang Kwon ◽  
Arash Shaban-Nejad
Keyword(s):  
Public Health ◽  
Chronic Disease ◽  
Network Analysis ◽  
Chronic Diseases ◽  
Chronic Conditions ◽  
Chronic Condition ◽  
Multiple Chronic Conditions ◽  
Socially Disadvantaged ◽  
Network Surveillance ◽  
The U.S

ObjectiveWe study how multimorbidity prevalence is related to socio-economic conditions in Memphis, TN. In addition, we demonstrate that the accumulation of chronic conditions, which is measured by affinity in multimorbidity, is unevenly distributed throughout thecity. Our research shows that not only are socio-economic disadvantages linked to a higher prevalence in each major chronic condition, but also major chronic conditions are heavily clustered in socially disadvantaged neighborhoods.IntroductionChronic diseases impose heavy burdens onhealth systems, economies, andsocieties (1). Half of all Americans live with at least one of the chronic conditions and more than 75% of health care cost is associated with people with chronic diseases (2). Multimorbidity, the coexistence of two ormore chronic conditions in an individual or a population, often require complex and ongoing care and a deep understanding of different risk factors, and their indicators.Multimorbidity has been increased over the past years and the trend is expected to continue across the U.S. Knowing how different chronic conditions are related to one another andwhat are the underlying socioeconomic factorsis crucial to design and implement effective health interventions. We introduce “multimorbidity network affinity”, which measures the degree of how multiple chronic conditions are clustered within a geographic unit. Accurate estimations of how chronic conditions are spatially clustered and linked to other sociomarkers(3) and socio-economic disadvantages facilitate designing effective interventions.MethodsMultiple datasets including major chronic condition data from the Center for Disease Control and Prevention (CDC) 500 cities, and socio-demographic data from the U.S. Census Bureau and the Environmental Systems Research Institute (ESRI) demographics data have been consistently integrated. Then, network analytics have been performed to examine the inter-relations among a selected number of major chronic conditions and their manifestations in Memphis. To checkwhether a distinctive geographic pattern in multimorbidity is present, we carried out a test using global Moran’s I and Getis-Ord Gi*statistics. If apattern is detected, we use robust regression to explore how affinity isassociatedwiththe socio-economic disadvantages of the area.ResultsThe network analysis confirms the existence of close relationships between various chronic conditions. Ourspatial analysisshowthat the geo-distinctive patterns of clustered comorbidities are associated with socio-economic deprivation. Statistical results suggest that neighborhoodswith higherrates of crime, poverty, and unemployment are associated with an increased likelihood of having dense clusters of chronic conditions.ConclusionsThis study shows the importance of geospatialfactors in multimorbidity network surveillance. Moreover, it demonstrates how socio-economic disadvantages and multimorbidity network are connected. The healthdisadvantages are disproportionately accumulated in socially disadvantaged areas. Network analysis enables us to discover the links between commonly co-observed chronic diseases and explore the complexity of their interactions. This will improve the surveillance practice and facilitate timely response as well as public health planning and decision making.References1. Wu S-Y, Green A. The Growing Crisis of Chronic Disease in the United States. RAND Corporation. 2000.2. Anderson G, Horvath J. The growing burden of chronic disease in America. Public health reports. 2004;119(3):263-70.3. Shin EK, Mahajan RM, Akbilgic OA, Shaban-Nejad A. Sociomarkers and Biomarkers: Predictive Modeling in Identifying Pediatric Asthma Patients at Risk of Hospital Revisits. npj Digital Medicine (2018) 1:50; doi:10.1038/s41746-018-0056-y. 

scholarly journals Do people with existing chronic conditions benefit from telephone coaching? A rapid review

2013 ◽  
Vol 37 (3) ◽  
pp. 381 ◽  
Author(s):  
Sarah M. Dennis ◽  
Mark Harris ◽  
Jane Lloyd ◽  
Gawaine Powell Davies ◽  
Nighat Faruqi ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Health Status ◽  
Chronic Diseases ◽  
Health Behaviour ◽  
Chronic Conditions ◽  
Chronic Condition ◽  
Vulnerable Groups ◽  
Health Record ◽  
Vulnerable People ◽  
Telephone Coaching

Objective. To examine the effectiveness of telephone-based coaching services for the management of patients with chronic diseases. Methods. A rapid scoping review of the published peer reviewed literature, using Medline, Embase, CINAHL, PsychNet and Scopus. We included studies involving people aged 18 years or over with one or more of the following chronic conditions: type 2 diabetes, congestive cardiac failure, coronary artery disease, chronic obstructive pulmonary disease and hypertension. Patients were identified as having multi-morbidity if they had an index chronic condition plus one or more other chronic condition. To be included in this review, the telephone coaching had to involve two-way conversations by telephone or video phone between a patient and a provider. Behaviour change, goal setting and empowerment are essential features of coaching. Results. The review found 1756 papers, which was reduced to 30 after screening and relevance checks. Most coaching services were planned, as opposed to reactive, and targeted patients with complex needs who had one or more chronic disease. Several studies reported improvements in health behaviour, self-efficacy, health status and satisfaction with the service. More than one-third of the papers targeted vulnerable people and telephone coaching was found to be effective for these people. Conclusions. Telephone coaching for people with chronic conditions can improve health behaviour, self-efficacy and health status. This is especially true for vulnerable populations who had difficulty accessing health services. There is less evidence for improvements in quality of life and patient satisfaction with the service. The evidence for improvements in health service use was limited. This rapid scoping review found that telephone-based coaching can enhance the management of chronic disease, especially for vulnerable groups. Further work is needed to identify what models of telephone coaching are most effective according to patients’ level of risk and co-morbidity. What is known about the topic? With the increasing prevalence of chronic diseases more demands are being made of limited health services and resources. Telephone health coaching for people with or at risk of chronic diseases is seen as a means of supporting people to manage their health and reducing the burden on the healthcare system. What does this paper add? Telephone coaching interventions were effective for vulnerable people with chronic disease(s). Often the vulnerable populations had worse control of their chronic condition at baseline and demonstrated the greatest improvement compared with those with better control at baseline. Planned (i.e. weekly or monthly telephone calls to support the patients with chronic disease) and unscripted telephone coaching interventions appear to be most effective for improving self-management skills in people from vulnerable groups: the planned telephone coaching services had the advantage of regular contact and helping people develop their skills over time, whereas the unscripted aspect allowed the coach to tailor support to the patient’s individual needs What are the implications for practitioners? Telephone coaching is an effective means of supporting people with chronic diseases to manage their own health. Further work is needed to embed telephone coaching within existing services. Good linkages with the patient’s general practitioner are important. This might be a regular report, updates via the patient e-health record, or provision for contact if a problem is identified or linking to the patient e-health record.

scholarly journals Social capital is associated with improved subjective well-being of older adults with chronic non-communicable disease in six low- and middle-income countries

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Aaron K. Christian ◽  
Olutobi Adekunle Sanuade ◽  
Michael Adu Okyere ◽  
Kafui Adjaye-Gbewonyo
Keyword(s):  
Older Adults ◽  
Social Capital ◽  
Chronic Diseases ◽  
Chronic Conditions ◽  
Chronic Condition ◽  
Well Being ◽  
Multiple Chronic Conditions ◽  
Subjective Well Being ◽  
Middle Income ◽  
Middle Income Countries

Abstract Background Non-communicable diseases (NCDs) are increasingly contributing to the morbidity and mortality burden of low and-middle income countries (LMIC). Social capital, particularly participation has been considered as a possible protective factor in the prevention and management of chronic conditions. It is also largely shown to have a negative effect on the well-being of patients. The current discourse on the well-being of individuals with NCDs is however focused more on a comparison with those with no NCDs without considering the difference between individuals with one chronic condition versus those with multiple chronic conditions (MCC). Method and objective We employed a multinomial logit model to examine the effect of social capital, particularly social participation, on the subjective well-being (SWB) of older adults with single chronic condition and MCC in six LMIC. Findings Social capital was associated with increased subjective well-being of adults in all the six countries. The positive association between social capital and subjective well-being was higher for those with a single chronic condition than those with multiple chronic conditions in India and South Africa. Conversely, an increase in the likelihood of having higher subjective well-being as social capital increased was greater for those with multiple chronic conditions compared to those with a single chronic condition in Ghana. Discussion The findings suggest that improving the social capital of older adults with chronic diseases could potentially improve their subjective well-being. This study, therefore, provides valuable insights into potential social determinants of subjective well-being of older adults with chronic diseases in six different countries undergoing transition. Additional research is needed to determine if these factors do in fact have causal effects on SWB in these populations.

scholarly journals Medication understanding and health literacy among patients with multiple chronic conditions: a study conducted in Bangladesh

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Fahad Imtiaz Rahman ◽  
Farina Aziz ◽  
Sumaiya Huque ◽  
Sadia Afruz Ether
Keyword(s):  
Health Literacy ◽  
Chronic Conditions ◽  
Chronic Condition ◽  
Healthcare Providers ◽  
Poor Health ◽  
Multiple Chronic Conditions ◽  
Multiple Chronic Condition ◽  
Convenience Sample ◽  
Individual Interviews ◽  
Reduce Medication Error

Objectives: Medication understanding is critical for patients who suffer from multiple chronic conditions in order to reduce medication error and is often associated with poor health outcomesand low adherence. This study aims to identify the gap of medication knowledge among multiple chronic condition patients in Bangladesh, in order to aid physicians and other healthcare providers in improving health literacy.Methods: Individual interviews of a convenience sample of multiple chronic condition patients in Bangladesh were heldwhere they were asked a number of questions for assessing medication related literacy.Results: More than 26% patients failed to cite the brand name of all their prescribed medications while the rate of patients not knowing the generic names was far worse (88.1%). Nearly 1 out of every 4 patients did not know the purpose of all their medications and more than half of the participants (55%) did not know the strengths of their drugs. While knowledge about medication routes and regimen was satisfactory, awareness regarding risk factors of medicine was lowest of all. Only 1 out of every 4 patients had a habit of reading drug information leaflet. Patient’s ability to correctly state the purpose of their medication seemed to be positively associated with age (p=0.004) and negatively associated with number of medicines taken (p=0.03).Conclusions: Many patients demonstrated poor health literacy regarding medication. Routine review of medications from physician or health provider can significantly improve their health literacy, leading to better treatment outcome and medication adherence.

scholarly journals The influence of primary health care organizational models on patients’ experience of care in different chronic disease situations

2011 ◽  
Vol 31 (3) ◽  
pp. 109-120 ◽  
Author(s):  
R Pineault ◽  
S Provost ◽  
M Hamel ◽  
A Couture ◽  
JF Levesque
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Primary Health Care ◽  
Chronic Disease ◽  
Chronic Diseases ◽  
Chronic Conditions ◽  
Chronically Ill ◽  
Organizational Models ◽  
Experience Of Care ◽  
Primary Health

Objectives To examine the extent to which experience of care varies across chronic diseases, and to analyze the relationship of primary health care (PHC) organizational models with the experience of care reported by patients in different chronic disease situations. Methods We linked a population survey and a PHC organizational survey conducted in two regions of Quebec. We identified five groups of chronic diseases and contrasted these with a no–chronic-disease group. Results Accessibility of care is low for all chronic conditions and shows little variation across diseases. The contact and the coordination-integrated models are the most accessible, whereas the single-provider model is the least. Process and outcome indices of care experience are much higher than accessibility for all conditions and vary across diseases, with the highest being for cardiovascular-risk-factors and the lowest for respiratory diseases (for people aged 44 and under). However, as we move from risk factors to more severe chronic conditions, the coordination-integrated and community models are more likely to generate better process of care, highlighting the greater potential of these two models to meet the needs of more severely chronically ill individuals within the Canadian health care system.

scholarly journals Cuidado à família da criança com doença crônica

2018 ◽  
Vol 12 (5) ◽  
pp. 1397
Author(s):  
Jessica Cardoso Vaz ◽  
Viviane Marten Milbrath ◽  
Ruth Irmgard Bärtschi Gabatz ◽  
Fábio Reis Krug ◽  
Bárbara Hirschmann ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Chronic Diseases ◽  
Chronic Conditions ◽  
Integrative Review ◽  
Virtual Library ◽  
Pediatric Nursing ◽  
Level Of Evidence ◽  
Families With Children ◽  
Children With Chronic Conditions

RESUMOObjetivo: conhecer o que vem sendo produzido sobre o cuidado à família da criança com doença crônica. Método: revisão integrativa que buscou conhecer as publicações dos últimos 10 anos nas bases de dados MEDLINE, LILACS, BDENF, INDEX PSICOL e na biblioteca virtual SciELO. Após a leitura dos artigos selecionados, foram analisados os dados dos estudos referentes à autoria, objetivos, ano de publicação, método e nível de evidência. Resultados: com base nos achados, foram definidas duas categorias temáticas << Enfrentando o diagnóstico da doença crônica, mudança de hábitos e reorganização familiar >> e << Rotinas de cuidado das famílias com crianças com condição crônica >>. Conclusão: as famílias das crianças com doença crônica são afastadas de suas rotinas, muitas vezes, perdendo o controle sobre suas vidas. Acredita-se que se a família for bem informada sobre a patologia e empoderada para os cuidados à criança, esta poderá desenvolver autonomia sobre a organização da sua vida. Descritores: Família; Criança; Doença Crônica; Empatia; Enfermagem Pediátrica; Revisão.ABSTRACT Objective: to know what has been produced about the care provided for families of children with chronic disease. Method: integrative review that sought to survey the publications of the last 10 years in the MEDLINE, LILACS, BDENF, INDEX PSICOL databases and in the virtual library SciELO. After reading the selected articles, we analyzed data of the studies regarding authorship, objectives, year of publication, method and level of evidence. Results: the findings led to two thematic categories << Facing the diagnosis of a chronic disease, change of habits and family reorganization >> and << Care routines of families with children with chronic conditions >>. Conclusion: Families of children with chronic diseases have their routines modified, often losing control over their lives. We believe that if families are well informed about the pathology and if they are empowered to care for the child, they will be able to develop autonomy over the organization of their lives. Descriptors: Family; Child; Chronic disease; Empathy; Pediatric Nursing; Review.RESUMEN Objetivo: conocer lo que viene siendo producido sobre el cuidado a la familia del niño con enfermedad crónica. Método: revisión integradora que buscó conocer las publicaciones de los últimos 10 años en las bases de datos MEDLINE, LILACS, BDENF, INDEX PSICOL y en la biblioteca virtual SciELO. Después de la lectura de los artículos seleccionados, fueron analizados los datos de los estudios referentes a la autoría, objetivos, año de publicación, método y nivel de evidencia. Resultados: con base en los hallados, fueron definidas dos categorías temáticas << Enfrentando el diagnóstico de la enfermedad crónica, cambio de hábitos y reorganización familiar >> y << Rutinas de cuidado de las familias con niños con condición crónica >>. Conclusión: las familias de los niños con enfermedades crónica son alejados de sus rutinas, muchas veces, perdiendo el control sobre sus vidas. Se cree que si la familia fuera bien informada sobre la patología y empoderada para los cuidados al niño, esta podrá desarrollar autonomía sobre la organización de su vida. Descriptores: Familia; Niño; Enfermedad Crónica; Empatía; Enfermería Pediátrica; Revisión.

scholarly journals Comorbid Chronic Conditions Among Older Adults with Subjective Cognitive Decline, United States, 2015–2017

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Christopher A Taylor ◽  
Erin D Bouldin ◽  
Kurt J Greenlund ◽  
Lisa C McGuire
Keyword(s):  
Cognitive Decline ◽  
Chronic Conditions ◽  
Chronic Condition ◽  
Functional Limitations ◽  
Functional Limitation ◽  
Subjective Cognitive Decline ◽  
Chronic Obstructive ◽  
Multiple Chronic Conditions ◽  
Chronic Obstructive Pulmonary Disorder ◽  
Increased Risk

Abstract Background and Objectives Subjective cognitive decline (SCD), the self-reported experience of worsening or more frequent confusion or memory loss, may be associated with the development or worsening of chronic conditions or complicating their self-management. The objectives of this study were to (i) establish the prevalence of chronic conditions and multiple chronic conditions among adults with SCD, and (ii) compare the prevalence of chronic conditions among people with and without SCD and SCD-related functional limitations. Research Design and Methods Data were analyzed from the Cognitive Decline module of the Behavioral Risk Factor Surveillance System administered in 49 states, DC, and Puerto Rico during 2015–2017. Analyses included 220,221 respondents aged 45 years or older who answered the SCD screening question and reported their chronic conditions. Weighted estimates were calculated and chi-square tests were used for comparisons. Results Persons with a history of stroke, heart disease, and chronic obstructive pulmonary disorder had significantly higher prevalence of SCD compared to those without. The prevalence of having at least one chronic condition was higher among adults with SCD compared to adults without SCD in each age group (45–64 years: 77.4% vs 47.1%, p &lt; .001; ≥65 years: 86.3% vs 73.5%, p &lt; .001). Among those with SCD, the prevalence of an SCD-related functional limitation was higher among those with at least one chronic condition compared to those with none (45–64 years: 63.3% vs 42.4%, p &lt; .001; ≥65 years: 40.0% vs 25.1%, p &lt; .001). Only half of adults with SCD and a chronic condition had discussed their SCD with a health care professional. Discussion and Implications SCD and chronic conditions commonly co-occur. Having a chronic condition was associated with greater SCD-related functional limitations. SCD might complicate the management of chronic conditions, and patients and providers should be aware of increased risk for cognitive decline in the presence of chronic diseases.

scholarly journals Association Between Speed of Multimorbidity Accumulation in Old Age and Life Experiences: A Cohort Study

2019 ◽  
Vol 188 (9) ◽  
pp. 1627-1636 ◽  
Author(s):  
Serhiy Dekhtyar ◽  
Davide Liborio Vetrano ◽  
Alessandra Marengoni ◽  
Hui-Xin Wang ◽  
Kuan-Yu Pan ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Elementary Education ◽  
Chronic Conditions ◽  
Life Experiences ◽  
Laboratory Data ◽  
Later Life ◽  
Adverse Outcomes ◽  
National Study ◽  
Multiple Chronic Conditions ◽  
Medical Histories

Abstract Rapidly accumulating multiple chronic conditions (multimorbidity) during aging are associated with many adverse outcomes. We explored the association between 4 experiences throughout life—childhood socioeconomic circumstances, early-adulthood education, midlife occupational stress, and late-life social network—and the speed of chronic disease accumulation. We followed 2,589 individuals aged ≥60 years from the Swedish National Study on Aging and Care in Kungsholmen for 9 years (2001–2013). Information on life experiences was collected from detailed life-history interviews. Speed of disease accumulation was operationalized as the change in the count of chronic conditions obtained from clinical examinations, medical histories, laboratory data, drug use, and register linkages over 9 years. Linear mixed models were used to analyze the data. Speed of disease accumulation was lower in individuals with more than elementary education (for secondary, β × time = −0.065, 95% CI: −0.126, −0.004; for university, β × time = −0.118, 95% CI: −0.185, −0.050); for active occupations compared with high-strain jobs (β × time = −0.078, 95% CI: −0.138, −0.017); and for richer social networks (for moderate tertile, β × time = −0.102, 95% CI: −0.149, −0.055; for highest tertile, β × time = −0.135, 95% CI: −0.182, −0.088). The association between childhood circumstances and speed of disease accumulation was attenuated by later-life experiences. Diverse experiences throughout life might decelerate chronic disease accumulation during aging.

Using pharmacy data to identify those with chronic conditions in Emilia Romagna, Italy

2005 ◽  
Vol 10 (4) ◽  
pp. 232-238 ◽  
Author(s):  
Vittorio Maio ◽  
Elaine Yuen ◽  
Carol Rabinowitz ◽  
Daniel Louis ◽  
Masahito Jimbo ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Disease Surveillance ◽  
Chronic Conditions ◽  
Chronic Condition ◽  
External Validation ◽  
Disease Status ◽  
Respiratory Illness ◽  
Gastrointestinal Diseases ◽  
Surveillance Study ◽  
Pharmacy Data

Background and objectives: Automated pharmacy data have been used to develop a measure of chronic disease status in the general population. The objectives of this project were to refine and apply a model of chronic disease identification using Italian automated pharmacy data; to describe how this model may identify patterns of morbidity in Emilia Romagna, a large Italian region; and to compare estimated prevalence rates using pharmacy data with those available from a 2000 Emilia Romagna disease surveillance study. Methods: Using the Chronic Disease Score, a list of chronic conditions related to the consumption of drugs under the Italian pharmaceutical dispensing system was created. Clinical review identified medication classes within the Italian National Therapeutic Formulary that were linked to the management of each chronic condition. Algorithms were then tested on pharmaceutical claims data from Emilia Romagna for 2001 to verify the applicability of the classification scheme. Results: Thirty-one chronic condition drug groups (CCDGs) were identified. Applying the model to the pharmacy data, approximately 1.5 million individuals (37.1%) of the population were identified as having one or more of the 31 CCDGs. The 31 CCDGs accounted for 77% (E556 million) of 2001 pharmaceutical expenditures. Cardiovascular diseases, rheumatological conditions, chronic respiratory illness, gastrointestinal diseases and psychiatric diseases were the most frequent chronic conditions. External validation comparing rates of the diseases found through using pharmacy data with those of a 2000 Emilia Romagna disease surveillance study showed similar prevalence of illness. Conclusions: Using Italian automated pharmacy data, a measure of population-based chronic disease status was developed. Applying the model to pharmaceutical claims from Emilia Romagna 2001, a large proportion of the population was identified as having chronic conditions. Pharmacy data may be a valuable alternative to survey data to assess the extent to which large populations are affected by chronic conditions.

scholarly journals The Effects of Chronic Disease on Ambulatory Care–Sensitive Hospitalizations for Children or Youth

2019 ◽  
Vol 12 ◽  
pp. 117863291987942
Author(s):  
Charles D Phillips ◽  
Chau Truong ◽  
Hye-Chung Kum ◽  
Obioma Nwaiwu ◽  
Robert Ohsfeldt
Keyword(s):  
Chronic Disease ◽  
Ambulatory Care ◽  
Chronic Diseases ◽  
Chronic Conditions ◽  
Ambulatory Care Sensitive Conditions ◽  
Hospital Discharges ◽  
Considerable Research ◽  
Complex Chronic Disease ◽  
Ambulatory Care Sensitive Hospitalizations ◽  
Ambulatory Care Sensitive

Considerable research has focused on hospitalizations for ambulatory care–sensitive conditions (ACSHs), but little of that research has focused on the role played by chronic disease in ACSHs involving children or youth (C/Y). This research investigates, for C/Y, the effects of chronic disease on the likelihood of an ACSH. The database included 699 473 hospital discharges for individuals under 18 in Texas between 2011 and 2015. Effects of chronic disease, individual, and contextual factors on the likelihood of a discharge involving an ACSH were estimated using logistic regression. Contrary to the results for adults, the presence of chronic diseases or a complex chronic disease among children or youth was protective, reducing the likelihood of an ACSH for a nonchronic condition. Results indicate that heightened ambulatory care received by C/Y with chronic diseases is largely protective. Two of more chronic conditions or at least one complex chronic condition significantly reduced the likelihood of an ACSH.

Evidence-Based Approach for Disaster Preparedness Authorities to Inform the Contents of Repositories for Prescription Medications for Chronic Disease Management and Control

2008 ◽  
Vol 23 (5) ◽  
pp. 447-457 ◽  
Author(s):  
David W. Brown ◽  
Stacy L. Young ◽  
Michael M. Engelgau ◽  
George A. Mensah
Keyword(s):  
Public Health ◽  
Chronic Disease ◽  
Chronic Conditions ◽  
Causes Of Death ◽  
Prescription Medication ◽  
Evidence Based ◽  
Narcotic Analgesics ◽  
Public Health Emergencies ◽  
Drug Classes ◽  
And Control

AbstractIntroduction:Chronic diseases are major causes of death and disability and often require multiple prescribed medications for treatment and control. Public health emergencies (e.g., disasters due to natural hazards) that disrupt the availability or supply of these medications may exacerbate chronic disease or even cause death.Problem:A repository of chronic disease pharmaceuticals and medical supplies organized for rapid response in the event of a public health emergency is desirable. However, there is no science base for determining the contents of such a repository. This study provides the first step in an evidence-based approach to inform the planning, periodic review, and revision of repositories of chronic disease medications.Methods:Data from the 2004 National Hospital Ambulatory Medical Care Survey (NHAMCS) were used to examine the prescription medication needs of persons presenting to US hospital emergency departments for chronic disease exacerbations. It was assumed that the typical distribution of cases for an emergency department will reflect the patient population treated in the days after a public health emergency. The estimated numbers of prescribed drugs for chronic conditions that represent the five leading causes of death, the five leading primary diagnoses for physician office visits, and the five leading causes of disease burden assessed by disability-adjusted life years are presented.Results:The 2004 NHAMCS collected data on 36,589 patient visits that were provided by 376 emergency departments. Overall, the five drug classes mentioned most frequently for emergency department visits during 2004 were narcotic analgesics (30.7 million), non-steroidal anti-inflammatory drugs (25.2 million), non-narcotic analgesics (15.2 million), sedatives and hypnotics (10.4 million), and cephalosporins (8.2 million). The drug classes mentioned most frequently for chronic conditions were: (1) for heart disease, antianginal agents/vasodilators (715,000); (2) for cancer, narcotic analgesics (53,000); (3) for stroke, non-narcotic analgesics (138,000); (4) for chronic obstructive pulmonary disease, anti-asthmatics/bronchodilators (3.2 million); and (5) for diabetes, hypoglycemic agents (261,000). Ten medication categories were common across four or more chronic conditions.Conclusions:Persons with chronic diseases have an urgent need for ongoing care and medical support after public health emergencies. These findings provide one evidence-based approach for informing public health preparedness in terms of planning for and review of the prescription medication needs of clinically vulnerable populations with prevalent chronic disease.

Sign in / Sign up

Export Citation Format

Share Document