Defining pharmacists' roles in disasters: A Delphi study

Autoři: Kaitlyn E. Watson aff001;  Judith A. Singleton aff001;  Vivienne Tippett aff001;  Lisa M. Nissen aff002
Působiště autorů: School of Clinical Sciences, Queensland University of Technology, Brisbane, Australia aff001;  Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia aff002
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article
doi: 10.1371/journal.pone.0227132



Pharmacists are uniquely placed in the community to be of assistance to disaster-affected patients. However, the roles undertaken by pharmacists in disasters are identified based on their own experiences and networks. There is currently no definition or acknowledgment of pharmacists’ roles in disasters.


To acquire consensus from an expert panel of key opinion leaders within the field of disaster health on pharmacists’ roles in disasters throughout the four disaster phases—prevention, preparedness, response, and recovery.


A Delphi study consisting of three rounds of online surveys was utilised. Twenty-four key opinion leaders were contacted, with 15 completing all three rounds. The 15 expert panellists were presented with 46 roles identified in the literature and asked to rank their opinions on a 5-point Likert scale. This study used an international, all-hazard, and multijurisdictional approach. Consensus was benchmarked at 80% and any role which did not reach consensus was re-queried in the subsequent round. The third round provided the results of the Delphi study and sought commentary on the acceptance or rejection of the roles.


Of the 46 roles provided to the expert panel, 43 roles were accepted as roles pharmacists are capable of undertaking in a disaster. There were five roles for the prevention phase, nine for the preparedness phase, 21 for the response phase, and eight for the recovery phase. The experts were asked to prioritise the top five roles for each of the disaster phases. The three roles which did not make consensus were deemed to be specialised roles for disaster pharmacists and not generalisable to the broader pharmacy profession.


This study identifies pharmacists’ roles in disasters which have been accepted by the international disaster health community. The international key opinion leaders recommended that pharmacists could be undertaking 43 roles in a disaster, however, this is dependent on individual jurisdiction considerations. Pharmacy professional associations need to advocate to policymakers for legislative support and to ensure pharmacists are equipped with the training and education required to undertake these roles within specific jurisdictions.

Klíčová slova:

Allied health care professionals – Cardiology – Critical care and emergency medicine – Drug administration – Drug research and development – Medical education – Patients – Pharmacists


1. The Pharmacy Guild of Australia. Submission in Response to the Competition Policy Review Draft Report. National Secretariat, Barton, ACT, 2014.

2. Scott S, Constantine LM. When natural disaster strikes. Am Pharm. 1990;NS30(11):27–8, 31. doi: 10.1016/s0160-3450(16)33636-4 2260522

3. Guynn J Jr. Disaster imminent—Hurricane Hugo. Hosp Pharm. 1990;25(4):325–8. 10104388

4. U. S. Department Of Health Education and Welfare. The Role of the Pharmacist in National Disaster. In: Office of Civil Defense DotA, editor. 1964.

5. Berod T, Chan-ou-Teung F. Pharmacist's Role in Rescue Efforts After Plane Crash in Indian Ocean. Am J Health Syst Pharm. 1997;54(9):1110–. doi: 10.1093/ajhp/54.9.1110 9143661

6. Ford H, von Waldner T, Perri M. Pharmacists’ Roles in Post-September 11th Disasters: A Content Analysis of Pharmacy Literature. J Pharm Pract. 2014;27(4):350–7. doi: 10.1177/0897190013507081 24128786

7. Ford H, Dallas CE, Harris C. Examining Roles Pharmacists Assume in Disasters: A Content Analytic Approach. Disaster Med Public Health Prep. 2013;7(06):563–72.

8. Ochi S HS, Landeg O, Mayner L, Murray V. Disaster-Driven Evacuation and Medication Loss: A Systematic Literature Review. PLoS Currents Disasters. 2014. doi: 10.1371/currents.dis.fa417630b566a0c7dfdbf945910edd96 25642363

9. Watson KE. The Roles of Pharmacists in Disaster Health Management in Natural and Anthropogenic Disasters. [PhD Thesis] [Thesis]. QUT ePrints: Queensland University of Technology; 2019.

10. Mullen E. The Essential Role of Pharmacists in Disasters [Internet] QS/1 News2014 [cited 2018-05-09]. Available from:

11. Watson KE, Singleton JA, Tippett V, Nissen LM. Do disasters predict international pharmacy legislation?. Aust Health Rev. 2019:-.

12. Currier M, King DS, Wofford MR, Daniel BJ. A Katrina Experience: Lessons Learned. Am J Med. 2006;119(11):986–92. doi: 10.1016/j.amjmed.2006.08.021 17071168

13. Young D. Pharmacists Play Vital Roles in Katrina Response More Disaster-Response Participation Urged. Am J Health Syst Pharm. 2005;62(21):2202–16. doi: 10.2146/news050025 16239405

14. Hogue MD, Hogue HB, Lander RD, Avent K, Fleenor M. The Non Traditional Role of Pharmacists After Hurricane Katrina: Process Description and Lessons Learned. Public Health Rep. 2009:217–23. doi: 10.1177/003335490912400209 19320363

15. Velazquez L, Dallas S, Rose L, Eva KS, Saville R, Wang J, et al. A PHS Pharmacist Team's Response to Hurricane Katrina. Am J Health Syst Pharm. 2006;63(14).

16. Angelo LB, Maffeo CM. Local and Global Volunteer Opportunities for Pharmacists to Contribute to Public Health. Int J Pharm Pract. 2011;19(3):206–13. doi: 10.1111/j.2042-7174.2011.00123.x 21554447

17. Pedersen CA, Canaday BR, Ellis WM, Keyes EK, Pietrantoni A, Rothholz MC, et al. Pharmacists’ Opinions Regarding Level of Involvement in Emergency Preparedness and Response. J Am Pharm Assoc (2003). 2003;43(6):694–701.

18. Pharmacy Traynor K., Public Health Intersect in Alabama Disaster Plans. Am J Health Syst Pharm. 2007;64(19):1998–9. doi: 10.2146/news070087 17893407

19. Ford JH. Pharmacists in Disasters [PhD Thesis]. Athens, Gerogia: University of Georgia; 2013.

20. Inspector-General for Emergency Management (IGEM), Victorian Government. Review of Response to the Thunderstorm Asthma Event of 21–22 November 2016: Final Report. 2017.

21. Boulkedid R, Abdoul H, Loustau M, Sibony O, Alberti C. Using and Reporting the Delphi Method for Selecting Healthcare Quality Indicators: A Systematic Review. PLoS One. 2011;6(6):e20476. doi: 10.1371/journal.pone.0020476 21694759

22. Sekayi D, Kennedy A. Qualitative Delphi Method: A Four Round Process with a Worked Example. The Qualitative Report. 2017;22(10):2755–63.

23. Beattie E, Mackway-Jones K. A Delphi Study to Identify Performance Indicators for Emergency Medicine. Emerg Med J. 2004;21(1):47–50. doi: 10.1136/emj.2003.001123 14734375

24. Rådestad M, Jirwe M, Castrén M, Svensson L, Gryth D, Rüter A. Essential Key Indicators for Disaster Medical Response Suggested to be Included in a National Uniform Protocol for Documentation of Major Incidents: A Delphi Study. Scand J Trauma Resusc Emerg Med. 2013;21(1):68.

25. Sinha IP, Smyth RL, Williamson PR. Using the Delphi Technique to Determine which Outcomes to Measure in Clinical Trials: Recommendations for the Future Based on a Systematic Review of Existing Studies. PLoS Med. 2011;8(1):e1000393. doi: 10.1371/journal.pmed.1000393 PMC3026691. 21283604

26. Kennie-Kaulbach N, Farrell B, Ward N, Johnston S, Gubbels A, Eguale T, et al. Pharmacist Provision of Primary Health Care: A Modified Delphi Validation of Pharmacists' Competencies. BMC Fam Pract. 2012;13(1):27. doi: 10.1186/1471-2296-13-27 22455482

27. Bisson JI, Tavakoly B, Witteveen AB, Ajdukovic D, Jehel L, Johansen VJ, et al. TENTS Guidelines: Development of Post-Disaster Psychosocial Care Guidelines Through A Delphi Process. Br J Psychiatry. 2018;196(1):69–74. Epub 01/02. doi: 10.1192/bjp.bp.109.066266 20044665

28. Zhong S, Clark M, Hou X-Y, Zang Y, Fitzgerald G. Development of Key Indicators of Hospital Resilience: A Modified Delphi Study. J Health Serv Res Policy. 2015;20(2):74–82. doi: 10.1177/1355819614561537 25504827

29. Cavallo A, Ireland V. Preparing for Complex Interdependent Risks: A System of Systems Approach to Building Disaster Resilience. Int J Disaster Risk Reduct. 2014;9:181–93. doi: 10.1016/j.ijdrr.2014.05.001

30. McGuire B. Global Disaster Paves Way for Global Thinking: In the Wake of the Indian Ocean Tsunami, Disaster Expert and Geophysicist Bill Mcguire Explains why Future Disaster Management Must Place a Greater Emphasis on Preparedness as well as Response. Geographical. 2005;77(3):14.

31. Leischow SJ, Milstein B. Systems Thinking and Modeling for Public Health Practice. Am J Public Health. 2006;96(3):403–5. doi: 10.2105/AJPH.2005.082842 16449572

32. Pratt G. Showcase Essential Pharmacy Practice Functions through Emergency Preparedness Efforts. Pharmacy Insights, A Look At: Emergency Preparedness. 2013:3–4.

33. Canadian Emergency Management College, Public Safety and Emergency Preparedness Canada. CBRN First Responder Training Program: Basic Level Pre-Course Reading. Ottawa, Ontario,: Government of Canada; 2008.

34. Terriff CM, Tee AM. Citywide Pharmaceutical Preparation for Bioterrorism. Am J Health Syst Pharm. 2001;58(3):233–7. doi: 10.1093/ajhp/58.3.233 11217178

35. Idemyor V, Smith SW. Biological Warfare—A Growing Healthcare Concern. Ann Pharmacother. 2002;36:1282–6. doi: 10.1345/aph.1A462 12125675

36. Canadian Pharmacists Association. Pharmacists' Scope of Practice in Canada [Internet] 2016 [cited 2018-08-07]. Available from:

37. Australian Red Cross, Australian Psychological Society. Psychological First Aid: An Australian Guide to Supporting People Affected by Disaster. Melbourne: 2013.

38. Rubio-Valera M, Chen T, #039, Reilly C. New Roles for Pharmacists in Community Mental Health Care: A Narrative Review. Int J Environ Res Public Health. 2014;11(10):10967. doi: 10.3390/ijerph111010967 25337943

39. O'Reilly CL, Bell JS, Kelly PJ, Chen TF. Impact of Mental Health First Aid Training on Pharmacy Students’ Knowledge, Attitudes and Self-Reported Behaviour: A Controlled Trial. Aust N Z J Psychiatry. 2011;45(7):549–57. doi: 10.3109/00048674.2011.585454 21718124

40. Machado C, Barlows TG, Marsh WA, Coto-Depani Y, Dalin G. Pharmacists on the Emergency Cardiopulmonary Resuscitation Team: Their Responsibilities, Training, and Attitudes. Hosp Pharm. 2003;38(1):40–9. doi: 10.1177/001857870303800113

41. Veltri KT, Yaghdjian V, Morgan-Joseph T, Prlesi L, Rudnick E. Hospital Emergency Preparedness: Push-POD Operation and Pharmacists as Immunizers. J Am Pharm Assoc (2003). 2012;52(1):81–5.

42. Hope D, Yeates G, King M. Vaccinations: Fragmented Federation: Inconsistent Interstate Requirements for Pharmacist Vaccine Administration. AJP: The Australian Journal of Pharmacy. 2016;97(1157):18–22.

43. Lau ET, Rochin ME, DelDot M, Glass BD, Nissen LM. “There’s No Touching in Pharmacy”: Training Pharmacists for Australia’s First Pharmacist Immunization Pilot. Can J Hosp Pharm. 2017;70(4):281. 28894312

Článek vyšel v časopise


2019 Číslo 12