Pharmacy services after a tank car derailment and toxic chemical release in Blount County, Tennessee

Abstract

Objectives: To assess the impact of an accidental release of volatilized acrylonitrile on pharmacy services in Blount County, Tennessee.

Methods: A paper questionnaire was mailed to all pharmacies located in Blount County, Tennessee. The questionnaire assessed 5 domains relevant to pharmacy services after the derailment disaster: (1) disaster preparedness, (2) disaster response, (3) disaster information source awareness, (4) Pharmacy Practice Act amendment preference, and (5) pharmacy impact. Continuous (ratio-level), binary, and free-text data were collected and evaluated with the use of multiple correspondence analysis, tetrachoric correlations, and multiple regression modeling.

Results: The data suggested that geographic proximity to and duration of the disaster and the number of patients presenting for 72-hour emergency prescription refills significantly influenced the overall impact on pharmacy service delivery. The increase in 72-hour prescription refill requests was strongly correlated with blood pressure and diabetes medications, with all respondents in favor of amending state law to allow pharmacists to dispense 30-day prescription refills in times of disaster. Pharmacy respondents are also largely unaware of online disaster-related information sources.

Conclusion: Disasters have the potential to affect all pharmacies in a locality but appear to have a significant impact on those located close to the scene. The number of patients presenting to pharmacies and the total duration of the disaster also appear to influence the overall impact of disasters on pharmacies. Pharmacists would be benefited by an awareness of current disaster information sources and legal supports pertinent to pharmacy practice in times of disaster.