Table 1.

Summary of disaster preparedness recommendations for major chronic illnesses

Stakeholder	Cancer	Cardiovascular diseases	Diabetes	Chronic respiratory diseases	Chronic kidney diseases
Patients	• Talk with health care provider about what to do and how to communicate in disaster situation • Make a plan with family, friends, and neighbors • Know exact diagnosis, cancer stage, medications • Ensure health care provider’s contact information • Carry insurance card • Prepare emergency kit • Keep logs of medication • Avoid clean-up in the disaster area if patients have received systemic therapy • Consider stopping anticancer therapy if patients have lost access to cancer specialists • Leave the disaster area if patients are receiving intravenous systemic therapy • Drink plenty of fluids	• Ensure that blood pressure medications are available during a disaster • Use medications that were prescribed prior to the disaster • Restrict salt intake • Keep adequate behavioral circadian rhythm with high-quality sleep	• Obtain self-management skills and stress management • Be up-to-date with all immunizations, including tetanus • Keep waterproof and insulated disaster kit ready; keep extra insulin and injection kits in multiple places • Learn the carbohydrate counting approach • Evacuate early	• Keep medications at hand • Be educated about their disease and treatment • Arrange for spare oxygen cylinders in case of electricity blackouts • Make a plan for evacuation to a health care facility	• Make a preparedness plan for emergency situations that include:  ◦ How to react during disasters when on dialysis  ◦ What to do if dialysis is postponed  ◦ Where to go if the hemodialysis unit is destroyed • Verify the location, capacity, and willingness to manage the extra patient load of a potential back-up dialysis center • For peritoneal dialysis patients, ensure a place to change bags and an uninterrupted supply of peritoneal dialysis fluids
Health care providers and policymakers	Health education • Educate patients regarding the names of their diseases, the intent of treatment (curative or palliative), the treatment regimen, previous surgery, pathology reports, and health insurance information Communication • Provide a list of frequently asked questions and available hospitals Information • Utilize surveillance system to estimate the number of cases Coordination • Create partnerships to provide comprehensive cancer control throughout a wider area	Patient management • Control blood pressure level (systolic blood pressure <140 mmHg and diastolic blood pressure <90 mmHg) • Monitor blood pressure and reconsider the dose of antihypertensive medication every 2 weeks • Use a long-acting calcium channel blocker for patients with newly developed hypertension or whose drug history has been lost • Consider using melatonin or mild sedatives for patients with disaster-related hypertension experiencing sleep disturbance or disrupted circadian rhythm Coordination • Develop Web-based patient monitoring system	Health education • Include diabetes educators on primary care teams to help with insulin adjustment and general diabetes education • (Critical step) disseminate information on how diabetes patients could obtain insulin injections Patient management • Try to prevent acute complications, rather than to aggressively control blood glucose levels • For type 2 diabetes using insulin, provide individualized care, including mental health care • For type 2 diabetes using oral hypoglycemic drugs, continue typical treatment regimens • Provide individualized recommendations if the patients have difficulties with access to medication and/or food	Patient management • Use simple patient assessment tools for efficient patient management through early detection and treatment of symptoms • Evacuate older patients from disaster areas quickly Information • Develop emergency operation measures, including a real-time patient locating system • Develop a storage system that contains regional prescription and personal medication data Coordination • Make a community-based plan for patients receiving home oxygen therapy	Patient management • Consider changing the routine treatment schedule for management of surge capacity Coordination • Prepare management plan for surge capacity • Transfer dialysis patients within or outside the disaster area