For Clinicians | Medication List Accuracy

For Clinicians | Medication List Accuracy: Nobody Has the Whole Picture Anymore

By Dr. Jamie Wilkey, PharmD, Director of Clinical Education
Medically reviewed and edited by Kristen Carpenter, PA-C

We’re closing out National Preparedness Month with the one step that costs nothing and that almost no patient has actually done: a medication record that’s correct.

As a pharmacist working in retail for many years, it became really clear to me that patients have a hard time keeping track of what they take. Especially polypharmacy patients, the ones on five or more medications. They don’t know all the drugs, the doses, who wrote those prescriptions, and sometimes even where they got it filled.

That’s not just a mess for the pharmacist trying to get a refill on the right medication. Deep down it’s a core problem for preparation and for healthcare in general. If there’s no one true source of what a patient is taking, in one place they can get to, it creates a ripple effect.

We are going to tackle this topic that seems simple, but is harder for your patients than you think. I’ll cover what patients actually bring us in the pharmacy, why no single record exists anymore, and how to work with a patient to start fixing it to get all of their medications in a record in one place.

What patients actually bring us

Ask a patient what they take and you’ll usually get the purpose, not the name. The blood pressure one. The thyroid one. The night blood sugar medicine. Not many know the full name, let alone the strength and the frequency. They get it from the pharmacist, put it in the organizer, and that’s the system.

When they do bring their medications in, it’s what we call brown bagging. A grocery bag on the counter, and we go through it vial by vial. They’re usually from different pharmacies and different doctors, and some aren’t being taken anymore. Just old vials still sitting in the house. Those vials are the only record that exists.

Then someone needs a transfer. They evacuated, or they’re traveling and out of refills. They hand me the bag as the pharmacist, or the handwritten note that says what everything is for but not what it is.It’s really hard to transfer a prescription I can’t identify (“your patient said they are taking a few medications for blood pressure and they need the one that is a red tablet sent over to us“), and I can’t call a prescriber about a medication I can’t name (“your patient said you gave them a pill last year for their mood. They need that refilled“).

How accurate are the lists patients do keep?

You might be thinking the patients who keep a list are fine. They aren’t.

In 138 patients at an urban emergency department in Australia, 75% of self-administered medication history forms had at least one discrepancy against a pharmacist-taken history, and 20% had at least one the authors judged high-risk ¹. In a US preoperative clinic, of 82 lists patients brought in themselves, 94% had at least one discrepancy against the clinic record, with a median of four per list ².

Both studies enrolled patients who produced a list at all. That’s the organized minority, the people who already did the thing we keep telling everyone to do. These numbers are the best case scenario. Yikes!

Nobody has the whole picture anymore

There used to be one record that tied it all together, and it was the insurance company because everything billed through them. Whatever pharmacy filled it, whichever doctor wrote it, all claims routed through the same company. That made the payer’s file the most comprehensive picture of what a patient was taking.

Now that behemoth that held everyone’s Rx history is coming apart. Patients frequently pay cash or use a discount card when it’s cheaper. They fill somewhere else because it’s faster. Some don’t want one company holding a list of everything they take and they intentionally fill for cash. Others don’t have insurance at all. And to add complexity to this, prescriptions start in more places now that there are so many new healthcare vertical companies with menopause from one service, weight loss from another, and mental health from a third. All on top of a primary care provider a patient already sees. 

So there’s no entity with the throughline anymore, and the patient became the record by default. We weren’t trained for this. Pharmacy school taught me a closed loop: one prescriber, one chart, one pharmacy that knew about both. That system is evaporating like a puddle on a hot summer day.

And before you assume your own office chart is the good copy: when researchers compared patient, GP, and community pharmacist records for 751 older patients in the Netherlands on an average of eight medications, the three sources disagreed for 71.9% of patients ³. There’s no correct copy for a patient to use or reference. Yikes!

The forms aren’t built to be patient-facing

So the patient is the walking medication record now. Nobody ever taught them how to do this, and the forms we hand them don’t help much.

Pull up any medication list template, the free federal one or whatever your clinic prints. They all start the same way: the name of the drug, and the strength. That’s what most just don’t know (especially those polypharmacy patients on 5+ medications). What they can tell you is that it’s the little white one for blood pressure.

So we hand someone a form that starts with the part they can’t do, and then we’re surprised when what comes back is wrong or half empty.

Here’s one thing you can use though. In that Australian study, the patients who left the pharmacy line blank had more than double the discrepancy rate, worse than patients on a long list of medications ¹. Tread carefully here…it predicts trouble, it doesn’t cause it. Filling the line in doesn’t make the rest of the list right. But a blank there tells you to slow down and ask more questions.

And to make matters worse, these patient-led records go stale fast. A patient fills one out in March, a specialist changes a dose in June, and nobody goes back to update it.

What actually works

Start with the one that already exists. Keep it simple!

If your patient is on Medicare Part D and meets the targeting criteria, their plan has to offer them a comprehensive medication review (CMR) every year, done by a pharmacist, at no cost to them ⁴. They walk out with a written summary in a standardized federal format, and that summary includes a personal medication list ⁵. I’ve done hundreds of these and they are fun. Most patients have never heard of them or think it is spam when a pharmacist calls them and offers to do one. 

When they don’t qualify for a CMR, or you want to do something today, print what you have. Have your MA pull the medication list off the chart and hand it over as a starting draft. Not a record. A draft. Make that clear it is just a springboard to start from because the minute a patient decides the office list is the authoritative one, they stop adding to it. And what’s missing from your chart is the whole point: the other prescribers, the cash fills, the online services, the supplements.

What the printout does is solve the naming of those medications. Your patient can’t write atorvastatin 40 milligrams from memory. They can absolutely correct a page that already says it and add “for cholesterol.” So they’re clear on how the name matches up with the indication

Then send them to their pharmacist with the bag. Brown bagging is helpful. In a randomized trial across three teaching hospitals in Colombia, a pharmacist-acquired history dropped the share of patients with at least one discrepancy from 93.6% to 60.7%⁶. A third better, and still wrong in six patients out of ten. That’s the ceiling, and it’s still the best we’ve got.

It’s also the only way an interaction check means anything, which we wrote about separately in The Drug Interactions You Create in an Emergency.

If you want a template to point them at, AHRQ’s is free, in English and Spanish, and it’s fine ⁷. No need to build your own.

This is what appropriate medical preparation looks like

Even in the best of times, when everything is working, it’s hard to help a patient nobody has a complete record for. In a disaster it compounds and makes everything worse.

The preparation that matters here is information, not inventory. A record the patient can actually get to, that says enough for someone else to act on it. None of this replaces primary care. Primary care is the bedrock for a patient building their Rx profile appropriately and accurately. 

That’s the work we do at Jase. We’re a team of physicians, physician assistants, and pharmacists, and we handle the clinical side ahead of time so a patient isn’t starting from zero when they can’t reach anyone. For the medications, patients complete an online intake for evaluation by a board-certified physician, which may include a live synchronous consult depending on their state. This record is a page your patient makes, and it’s the half of preparation we can’t do for them.

The bottom line

My grandma had this figured out on her own. She was on warfarin and knew how tricky that medication was with drug and food interactions. So she didn’t leave anything to chance. She typed her medications out on one page: the name, what it was for, the strength, the doctor who wrote it, and the pharmacy that filled it. Then she printed it and kept it in the kitchen, where someone (like an emergency responder) could easily and clearly find it.

Follow her great example! A simple Word document or the notes app works great. What it needs is to travel with the patient, to be findable by somebody else, and to have a date on it. Then update it once a year at the physical (at a minimum, and ideally whenever anything changes with their medications or supplements). It won’t be perfect. Even a pharmacist taking a full history doesn’t get it perfect. But a dated, mostly-right list that a stranger can find beats a grocery bag every time.


Sources

  1. Wai A, Salib M, Aran S, Edwards J, Patanwala AE. Accuracy of patient self-administered medication history forms in the emergency department. American Journal of Emergency Medicine. 2020;38(1):50-54. Cross-sectional study, urban emergency department, Australia, 138 patients. https://pubmed.ncbi.nlm.nih.gov/31005394/
  2. Lee KP, Nishimura K, Ngu B, Tieu L, Auerbach AD. Predictors of Completeness of Patients’ Self-reported Personal Medication Lists and Discrepancies With Clinic Medication Lists. Annals of Pharmacotherapy. 2014;48(2):168-177. Academic hospital preoperative clinic, 82 patient-brought lists, data collected January to October 2010. https://doi.org/10.1177/1060028013512109
  3. Bosch-Lenders D, Stoffers HEJH, Winkens B, Twellaar M, Hufen WJM, et al. Discrepancies in prescribed medications as reported by patients, general practitioners, and community pharmacists in older patients with polypharmacy in primary care. BMC Primary Care. 2026. 751 patients across 24 general practices and 17 community pharmacies, the Netherlands. https://doi.org/10.1186/s12875-026-03332-3
  4. Centers for Medicare and Medicaid Services. Medication Therapy Management. Part D sponsors must establish an MTM program, and programs may be delivered by pharmacists or other qualified providers. Contract year 2026 targeting criteria are described in the CY 2026 Medicare Advantage and Part D final rule fact sheet. https://www.cms.gov/medicare/coverage/prescription-drug-coverage-contracting/medication-therapy-management
  5. Centers for Medicare and Medicaid Services. Medicare Part D Medication Therapy Management Program Standardized Format, frequently asked questions. Sponsors must at a minimum offer a comprehensive medication review annually to targeted beneficiaries, and the written summary provided to the beneficiary includes a Personal Medication List and a Medication Action Plan. https://www.cms.gov/medicare/prescription-drug-coverage/prescriptiondrugcovcontra/downloads/mtm-program-standardized-format-faqs-v08-1512-.pdf
  6. Becerra-Camargo J, Martinez-Martinez F, Garcia-Jimenez E. A multicentre, double-blind, randomised, controlled, parallel-group study of the effectiveness of a pharmacist-acquired medication history in an emergency department. BMC Health Services Research. 2013;13:337. Three teaching hospitals in Bogota, Colombia, 242 patients completed. https://pmc.ncbi.nlm.nih.gov/articles/PMC3844415/

 

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For Clinicians | Medication List Accuracy

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Carbon Monoxide After the Storm

Carbon Monoxide After the Storm: The Symptoms Mistaken for the Flu

By the Jase Medical Team

The storm has passed, but the power is still out.

It’s raining, so the generator gets moved a little closer to the house—maybe under the porch or near an open garage. You’re making do, charging phones, keeping the refrigerator cold, trying to get through another day without power.

By day three, everyone feels terrible.

You’ve got a headache. Your spouse is nauseated. Someone feels weak and achy. Maybe the dog isn’t acting like itself either.

In February, it’s easy to think: The flu finally got us.

In July: Probably the heat. Maybe a stomach bug.

But there’s one question that should make you consider something entirely different:

Does everyone in the house feel sick at the same time—and do you start feeling better when you leave?

If the answer is yes, get everyone outside into fresh air and call 911. Carbon monoxide could be the reason.

Why Carbon Monoxide Can Look Like the Flu

Carbon monoxide (CO) is a colorless, odorless gas produced when fuels don’t burn completely. Generators, charcoal grills, vehicles, and other fuel-burning equipment can all produce it.

After storms and power outages, the risk increases because people start improvising.

A generator gets moved closer to the house because it’s raining. A grill gets pulled into a garage. A vehicle is left running in an enclosed or partially enclosed space.

The problem is that early carbon monoxide poisoning doesn’t necessarily look like poisoning.

It can cause headache, dizziness, weakness, nausea, vomiting, chest discomfort, and confusion.

Those symptoms overlap with plenty of ordinary illnesses.

That’s why the symptom list isn’t necessarily the most useful thing to remember.

The pattern is.

The Question That Can Break the Case Open

Imagine you’ve had a headache all morning.

You drive somewhere to pick up supplies and realize that after being away from the house for a while, you feel noticeably better.

You come home.

The headache returns.

Then you realize your spouse has a headache too. Someone else feels nauseated. The dog is unusually sluggish.

A virus can certainly spread through a household. But several people becoming sick at roughly the same time—and improving when they’re away from the same environment—is an important clue that the environment itself may be the problem.

Carbon monoxide exposure can affect multiple people sharing the same space.

So after a storm or during a power outage, remember this question:

Who else feels sick, and do we feel better when we leave?

If that pattern is present, don’t stay inside trying to determine whether it’s the flu, heat exhaustion, food poisoning, or carbon monoxide.

Get out.

A Normal Pulse Oximeter Doesn’t Rule Out Carbon Monoxide

This is an especially important misconception if you keep a fingertip pulse oximeter at home.

You feel terrible, put it on your finger, and see: 98%.

That can feel reassuring.

With suspected carbon monoxide poisoning, it shouldn’t.

A standard two-wavelength pulse oximeter cannot reliably distinguish normal oxygen-carrying hemoglobin from hemoglobin carrying carbon monoxide. As a result, the number displayed on a typical home pulse oximeter can appear normal even when significant carbon monoxide exposure has occurred.

A normal pulse ox reading does not rule out carbon monoxide poisoning.

If the circumstances and symptoms make you suspect CO, don’t use a reassuring-looking oxygen saturation number as a reason to stay inside.

What Should You Do If You Suspect Carbon Monoxide?

The immediate action is straightforward:

Get everyone out of the building and into fresh air. Then call 911.

Don’t remain inside looking for the source. Don’t wait to see whether the headache improves. Don’t rely on opening a window or door and staying in the home.

Emergency medical professionals can evaluate the exposure and provide oxygen and other treatment as appropriate.

If someone is confused, collapses, loses consciousness, has significant difficulty breathing, or is otherwise severely ill, treat it as an emergency.

And don’t forget everyone sharing the environment—including pets. If multiple members of the household seem unexpectedly sick at once, that’s part of the clue.

Generators Need Distance From the House

Generators are one of the most important carbon monoxide risks following storms.

They should be operated outdoors and away from the home, not inside a house, garage, basement, shed, carport, porch, or other enclosed or partially enclosed area.

Moving one “just under the porch” to keep it out of the rain can unintentionally move carbon monoxide closer to doors, windows, and vents where exhaust can enter the home.

The same principle applies to other fuel-burning equipment.

A charcoal grill doesn’t become safe to use indoors because the power is out. A vehicle shouldn’t be left running inside a garage to generate power or charge devices.

If it burns fuel, think about where the exhaust is going.

One of the Best Preparedness Tools Is Already on the Wall

There is a simple layer of protection that doesn’t require recognizing symptoms at all:

working carbon monoxide alarms.

Install CO alarms on every level of your home and outside sleeping areas, and make sure they’re functioning properly.

If an alarm sounds, move everyone outside and follow emergency guidance. Don’t assume it’s malfunctioning because nobody feels sick yet.

A CO alarm can identify the problem before your body has to.

Sometimes Preparedness Is Knowing Which Question to Ask

After a hurricane, tornado, winter storm, or extended power outage, there are plenty of things competing for your attention.

Is the refrigerator staying cold? Do you have enough fuel? When will the electricity come back? Is everyone hydrated? Can you get to the pharmacy?

Carbon monoxide doesn’t necessarily announce itself as a dramatic emergency. Sometimes it looks like a family that simply feels lousy on day three.

That’s why appropriate medical preparation isn’t just a shelf full of supplies.

Sometimes it’s knowing enough to notice when the story doesn’t fit.

At Jase Medical, we’re a family team of medical doctors, PAs, and pharmacists focused on that grey space—the moments when normal healthcare access and normal routines are disrupted, and knowing what to do next matters.

We’re not a replacement for primary care or emergency medicine.

We’d simply rather you recognize this pattern on day one:

If everyone in the house feels sick at the same time and starts feeling better when they leave, get out into fresh air and call 911.

Don’t let a normal pulse oximeter reading talk you out of it.


The Jase Medical Team is a family team of medical doctors, PAs, and pharmacists focused on appropriate medical preparation: clinically grounded readiness that complements, rather than replaces, the healthcare professionals you already trust.

This article was prepared by the Jase Medical content team for informational purposes only and does not constitute medical advice. Prescription requirements, emergency dispensing rules, insurance coverage, and controlled-substance regulations vary by medication, jurisdiction, and individual circumstances. Consult a licensed healthcare provider or pharmacist regarding your specific medications.

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Everyone should be empowered to care for themselves and their loved ones during the unexpected. Check out our recent lifesaving products today.

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For Clinicians | Medication List Accuracy

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For Clinicians | Why Patients Run Out of Medication

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For Clinicians | Why Patients Run Out of Medication: The Ordinary Disruptions, Not the Disaster By Dr. Jamie Wilkey, PharmD, Director of Clinical EducationMedically reviewed and edited by Kristen Carpenter, PA-C As a pharmacist, I've helped patients keep access to...

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Join Our Newsletter

Our mission is to help you be more medically prepared. Join our newsletter and follow us on social media for health and safety tips each week!

Why Patients Run Out of Meds

Why Patients Run Out of Meds: Ordinary Disruptions

By the Jase Medical Team

Most people who unexpectedly lose access to a prescription didn’t lose it in a hurricane.

A bottle gets left in a hotel room. A suitcase doesn’t make the flight. Medication disappears during a move. A prescription is stolen from a car. A house fire destroys everything in the medicine cabinet. Someone accidentally knocks a bottle into water and the medication can no longer be used.

These are ordinary disruptions, and there’s an important difference between them and a declared disaster: the healthcare system may have more emergency mechanisms available during the hurricane than it does on an ordinary Tuesday.

When there’s no disaster declaration or emergency order, replacing medication often comes down to your insurance plan’s own lost, stolen, or damaged medication policy. Those policies can be surprisingly limited.

That’s why the most useful preparation isn’t necessarily having more medication. It’s knowing who to call, what your plan allows, and having the information you’ll need when you make that call.

Does Insurance Replace Lost Medication?

Sometimes, but don’t assume that it will automatically.

Health plans and pharmacy benefit programs can have specific limits on how often they’ll authorize an early refill or replacement because medication was lost, stolen, or damaged. Depending on your coverage, there may be restrictions on how frequently an override is available or additional steps required before the replacement can be processed.

That means one of the simplest medication-preparedness questions you can ask today is:

“What is my plan’s policy if my medication is lost, stolen, or damaged?”

Call the member-services number on your insurance card or ask your pharmacist how your plan typically handles a lost-medication override. You don’t need to wait until something is missing to understand the process.

If your medication actually is lost or damaged, contact your pharmacy and insurance plan promptly. They can tell you what your specific coverage allows and whether your prescriber needs to become involved.

A Replacement May Not Mean Another Full Month

There’s another detail that can surprise people: replacing a lost prescription doesn’t necessarily mean receiving an entirely new month’s supply.

Depending on the medication, prescription, insurer, and circumstances, the replacement process may account for how much of the original supply should still have remained.

For example, if you’re halfway through a prescription when the remaining medication is lost, the replacement may be handled differently than if an unopened prescription disappears the day you pick it up.

The important point isn’t to calculate the replacement yourself. It’s not to assume that “replacement” automatically means starting the prescription cycle over.

Your pharmacist and insurance plan can explain how the remaining quantity will be handled in your particular situation.

If Your Medication Was Stolen, Document It

Losing medication and having medication stolen may trigger different requirements.

If you believe a prescription was stolen, contact your pharmacy and insurer and ask exactly what documentation they require. A police report may be required before an insurer or pharmacy can move forward with certain replacement requests.

If you’re instructed to file one, keep a copy or the report information somewhere accessible. Having that documentation ready can prevent another round of calls when you’re already trying to replace something you need.

And be precise when you explain what happened. “I lost my medication” and “my medication was stolen” may not be treated as the same situation.

Controlled Substances Follow Tighter Rules

If the medication you’ve lost is a controlled substance, don’t assume the same replacement process applies.

Controlled medications are subject to additional federal and state requirements, and the rules can vary based on the medication’s schedule and circumstances. A pharmacist may not be able to simply replace the medication or process an ordinary early refill.

If you’ve lost a controlled-substance prescription, contact your prescriber promptly as well as your pharmacy. Your prescriber may need to issue a new prescription or determine the appropriate next step.

Don’t try to compensate for missing medication by stretching, skipping, changing, or rearranging doses yourself. Ask the clinician managing the prescription what they want you to do while the situation is being resolved.

This is also worth discussing before you ever lose the medication. If you regularly take a controlled substance, ask your prescriber what process they want you to follow if it is ever lost, stolen, or destroyed.

Why a Declared Disaster Can Be Different

A major disaster doesn’t make medication access easy, but it can activate systems that aren’t necessarily available after an ordinary medication loss.

Depending on the disaster, location, insurance coverage, and emergency declarations in effect, additional mechanisms may become available to help people maintain access to necessary prescriptions. Government programs, insurers, pharmacies, and state authorities may implement temporary policies designed specifically for affected communities.

That’s an important distinction.

A suitcase lost during an ordinary vacation and a medicine cabinet destroyed during a federally declared hurricane may leave you with the same practical problem – your medication is gone – while putting you into very different administrative systems for replacing it.

So don’t assume advice you read about emergency refills during hurricanes automatically applies when medication disappears during an ordinary week. Start with your pharmacist, insurance plan, and prescriber and ask what applies to your specific situation.

Keep One Medication Record You Can Grab Anywhere

Regardless of why medication goes missing, one simple piece of preparation makes almost every conversation easier: keep a current medication list.

For each prescription, record the medication name, dose, prescriber, and pharmacy. If you take several medications, keep the list somewhere you can access without relying entirely on a patient portal or pharmacy app.

That record isn’t a replacement prescription, but it gives the people helping you a much better starting point. If you’re standing at an unfamiliar pharmacy after losing your suitcase, calling an insurance company after a house fire, or trying to reach a prescriber about a controlled medication, you don’t want to reconstruct your medication history from memory.

This is one of the simplest forms of appropriate medical preparation because it costs nothing and doesn’t require accumulating additional medication. You’re preparing the information, not stockpiling the prescription.

Know the Process Before You Need It

At Jase Medical, we’re a family team of medical doctors, PAs, and pharmacists focused on appropriate medical preparation: understanding where normal healthcare access can break down and making clinically responsible plans before it does.

And sometimes the disruption isn’t dramatic at all. It’s a suitcase that didn’t arrive, a bottle damaged at home, a prescription stolen from a car, or a house fire that never makes the national news.

We’re not a replacement for primary care, your pharmacist, or your insurance plan. In this situation, those relationships are exactly what you need. We would simply rather you understand the process on a normal week than learn it while standing at the pharmacy counter without the medication you depend on.

So if you take regular prescriptions, do two things now: keep a current record of your medications, doses, prescribers, and pharmacy, and find out how your insurance plan handles medication that is lost, stolen, or damaged.

Because medication preparedness isn’t only about hurricanes, evacuations, or widespread emergencies. More often, it’s about being ready for the ordinary disruption you never expected to become a medical problem.


The Jase Medical Team is a family team of medical doctors, PAs, and pharmacists focused on appropriate medical preparation: clinically grounded readiness that complements, rather than replaces, the healthcare professionals you already trust.

This article was prepared by the Jase Medical content team for informational purposes only and does not constitute medical advice. Prescription requirements, emergency dispensing rules, insurance coverage, and controlled-substance regulations vary by medication, jurisdiction, and individual circumstances. Consult a licensed healthcare provider or pharmacist regarding your specific medications.

Lifesaving Solutions

Everyone should be empowered to care for themselves and their loved ones during the unexpected. Check out our recent lifesaving products today.

Recent Posts

Keeping you informed and safe.

For Clinicians | Medication List Accuracy

For Clinicians | Medication List Accuracy

For Clinicians | Medication List Accuracy: Nobody Has the Whole Picture Anymore By Dr. Jamie Wilkey, PharmD, Director of Clinical EducationMedically reviewed and edited by Kristen Carpenter, PA-C We're closing out National Preparedness Month with the one step that...

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Why Patients Run Out of Meds

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For Clinicians | Why Patients Run Out of Medication

For Clinicians | Why Patients Run Out of Medication

For Clinicians | Why Patients Run Out of Medication: The Ordinary Disruptions, Not the Disaster By Dr. Jamie Wilkey, PharmD, Director of Clinical EducationMedically reviewed and edited by Kristen Carpenter, PA-C As a pharmacist, I've helped patients keep access to...

read more

Join Our Newsletter

Our mission is to help you be more medically prepared. Join our newsletter and follow us on social media for health and safety tips each week!

For Clinicians | Why Patients Run Out of Medication

For Clinicians | Why Patients Run Out of Medication: The Ordinary Disruptions, Not the Disaster

By Dr. Jamie Wilkey, PharmD, Director of Clinical Education
Medically reviewed and edited by Kristen Carpenter, PA-C

As a pharmacist, I’ve helped patients keep access to their medications through real disasters (especially wildfires out here in Utah). Much much more commonly, I spent my time behind the counter helping patients get access to their medications during ‘normal life.‘ No epic natural or structural disaster caused the disruption, but it was still a giant pain for my patients to deal with.

Some of what got in their way, patients could do something about: whether they had a ride that week, or whether they could pay for their medications when they got to the counter.

The rest was totally out of their hands. 

  • A manufacturer stops making a product and the shortage runs for months (and we covered how long those actually last here). 
  • The pharmacy that filled their prescriptions for twenty years just closed.
  • Their prescriber leaves the practice and the refill request sits in a queue nobody is watching. 
  • The insurance plan changes its coverage rules on January 1 and nobody clearly loops in the patient on that
  • The local chain pharmacy keeps temporarily closing due to staff shortages

Today we’re walking through both: what patients can stay ahead of, and what is out of their control. Most of the practical tips sit in that second group, because that’s where patients have the least wiggle room. It’s not quite as exciting as a full-scale disaster, but it’s a part of daily life I believe you should be prepared for because I dealt with it in some form daily with my patients for over a decade.

What patients can get ahead of

Cost is a big factor. 

  • About 8% of US adults taking a prescription didn’t take it as prescribed in order to save money¹. Patients are getting better about raising the issue of medication cost with you in the appointment. GoodRx is the best tool we have here, especially for anyone with a high copay or anyone choosing not to run it through insurance. It’s a good, simple way to eyeball the cash cost of an Rx ahead of time. 

Travel is the one that arrives as an emergency. 

  • Someone flies out Thursday and realizes Wednesday afternoon they don’t have enough medications for the trip. Their home pharmacy already has the prescriptions on file and can usually put together a vacation supply, but that takes lead time and sometimes a call to the plan. A pharmacy at their destination has none of their history and far less to work with. Tell patients to start working on their medications weeks before the departure date, not the night before (especially for overseas travel!). The more warning we in the pharmacy get, the more we can do, and their emergency doesn’t have to become ours.

For patients who depend on someone else for a ride, the best fix is usually removing the trip entirely. 

  • I worked for a big chain for years, and it was clear that delivery there is a low priority and gets missed very often. A locally owned pharmacy that delivers is a different experience: you get to work with the same humans every time, and they have a stake in it going right. Mail order can work as well, depending on how easy the company is to work with. Some are atrocious and others are the easiest thing in the world. 

And finally, theft. 

  • Theft as a loss for medications is more infrequent, and almost always a controlled substance and almost always someone living in the house with the patient. There isn’t much a pharmacy can do with it. The patient needs a police report, and for a Schedule II they need a new prescription from the prescriber, because those can’t be refilled at all.

What’s out of their hands:

  • The drug is on shortage: ASHP was tracking 227 active drug shortages as of mid-2026, the third straight quarterly increase². Even so, the pharmacy has more room here than patients expect. We can usually work with whatever we have of it in stock, and at a chain we can see which nearby stores are holding it and send the prescription over so it’s in process within minutes. Patients can call around themselves, and once they find a pharmacy that has it, that pharmacy can pull it across. When it’s really gone gone everywhere, that’s when we need a new prescription from you. 
  • Their pharmacy closed for good: Nearly one in three US retail pharmacies closed between 2010 and 2021, and roughly a third of counties ended that period with fewer pharmacies than they started with³. When a pharmacy closes, whoever bought the files now has the prescriptions, so nothing vanishes. Patients will feel friction on the first few fills, because pulling another location’s information into our system takes longer than it looks. They should have gotten a letter, but profile addresses are almost always outdated, so there’s no guarantee the patient heard anything ahead of time. Tell them to expect a few extra days and start the refill process early with a new pharmacy.
  • Their pharmacy is closed today: We’ve had a pharmacist shortage across Utah for a while, so stores that should be open Saturday aren’t, and some close mid-day when nobody can cover a shift. It’s not just Utah, but all across the US. Patients find out by driving there and seeing a handwritten sign: ‘closed due to pharmacist/staff shortage, will reopen on X date/time.’ Chains are more exposed to staffing shortages, and also easier to recover from, because any store in the chain can see the profile and patch around the closed one.
  • The refill request never reached you: This is usually a routing problem. Pharmacy systems grab the first address on file for a prescriber rather than the clinic the prescription came from, which breaks constantly for urgent care and for anyone practicing at several sites. If you’ve wondered where those requests go, that’s where.
  • It’s January: Formularies change, and the bigger shock is the deductible resetting. The patient who paid nothing in December pays full price until they clear it, up to $615 on Part D this year⁴. The year has a shape now: expensive at the start, copays through the middle, then nothing once they hit the $2,100 cap⁴. Insurance doesn’t explain any of that. We do, at the counter, and we hate it too. We don’t set the prices. We just charge what insurance tells us to charge. 
  • You don’t know whether the plan will cover it: Plan policies vary wildly, so don’t guess. Pharmacy billing is live, so as soon as we get the Rx we can tell you on the spot whether the plan will cover a vacation supply, an early refill, or a replacement. It isn’t a medical claim and it doesn’t take days. 

Two things from the pharmacy side prevent most of what’s in this article.

Write for 90 days at a time wherever the clinical picture allows it. I know most of you are doing that already. Keep it up! More insurers are covering 90 days supplies and it really does help a lot. 

This feels obvious, but make sure the right office phone number is on the prescription when you eRx it over. I’ve lost a lot of time calling the number on file and finding out the prescriber is somewhere else that day.

Last Thought

We’re a medical preparation company, and most of what we publish is about disasters. This is the other half of the same work. Appropriate medical preparation fits in daily life as well, not just big behemoth disasters. The same habits carry a patient through a wildfire, and they’ll use them far more often on an ordinary Tuesday. None of it replaces primary care. It’s the layer underneath, that keeps everything humming along.

Patients who are prepared are easier to take care of. They call before they’re out, they know what they take and who prescribes it, and the care goes better on both sides of the counter.


Sources

  1. Mykyta L, Cohen RA. Characteristics of Adults Aged 18–64 Who Did Not Take Medication as Prescribed to Reduce Costs: United States, 2021. NCHS Data Brief No. 470. National Center for Health Statistics, June 2023. Cost-saving measures included skipping doses, taking less medication than prescribed, or delaying filling a prescription. https://www.cdc.gov/nchs/data/databriefs/db470.pdf
  2. American Journal of Managed Care. Active US Drug Shortages Rise for Third Straight Quarter. 227 active shortages as of Q2 2026, reporting ASHP tracking data. https://www.ajmc.com/view/active-us-drug-shortages-rise-for-third-straight-quarter
  3. Health Affairs, December 3, 2024. DOI 10.1377/hlthaff.2024.00192. Nearly one in three US retail pharmacies closed between 2010 and 2021; roughly one-third of counties saw a net decline in pharmacies. Summary: https://schaeffer.usc.edu/research/pharmacy-closures-united-states-health-affairs/
  4. Centers for Medicare & Medicaid Services. Final CY 2026 Part D Redesign Program Instructions. Annual deductible $615; annual out-of-pocket threshold $2,100. https://www.cms.gov/newsroom/fact-sheets/final-cy-2026-part-d-redesign-program-instructions

 

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The Drug Interactions You Create in an Emergency

The Drug Interactions You Create in an Emergency

By the Jase Medical Team

Most of the time, you don’t have to think very hard about drug interactions. Your doctor has your medication list. Your pharmacy has it too. When a new prescription comes through, software checks it against the medications already on file, and your pharmacist reviews the combination and steps in when something doesn’t look right.

Then the storm hits.

Your usual pharmacy is closed. You’re buying cold medicine at a grocery store two towns over. Maybe you’re dealing with an injury, respiratory illness, allergies, or another problem on top of the four or five prescriptions you already take every day. Suddenly, the drug-interaction check stops being software and becomes a person. And that person may be you.

The good news is that you don’t need to memorize a database of drug interactions to prepare for that possibility. For most people, there are two much more practical things to do: learn to spot duplicate ingredients in common over-the-counter medications, and have one conversation with your pharmacist about the prescriptions you already take.

First: Watch for the Same Ingredient in More Than One Product

One of the easiest medication mistakes to make during a stressful week doesn’t look like a drug interaction at all. You have a headache and fever, so you take acetaminophen. Later, your congestion gets worse, so you reach for a multi-symptom cold and flu product. That night, you consider something marketed for nighttime symptoms.

The problem is that more than one of those products may contain acetaminophen.

Acetaminophen appears in many over-the-counter cold and flu products, combination pain relievers, nighttime formulas, and some prescription pain medications. That means it’s possible to take the same active ingredient from multiple products simply because each package has a different name and purpose.

During an emergency, you’re probably not shopping for something labeled simply “acetaminophen.” You’re shopping for “Cold + Flu,” “Severe,” “Nighttime,” or “Pain Relief.” Those names describe what the product is marketed to treat, but they don’t necessarily make it obvious what’s actually inside.

Before combining over-the-counter medications—or taking one alongside a prescription medication—turn the package around and look at the Active Ingredients section. If you see acetaminophen listed in more than one product you’re considering, stop and ask a pharmacist or another qualified healthcare professional before combining them.

The goal isn’t to start calculating or rearranging doses yourself. It’s simply to know what’s actually in what you’re taking.

A Disaster Adds Medications to a List You Already Had

Think about what happens medically during an ordinary bad week after a storm. Someone hurts their back clearing debris and wants a pain reliever. Someone develops a respiratory illness and reaches for cold medicine. Someone gets stung or develops a rash and considers an antihistamine. Someone develops an infection and is prescribed an antibiotic.

None of those situations is particularly unusual. But those new medications aren’t entering an empty medicine cabinet. They’re being added to the blood pressure medication, anticoagulant, diuretic, psychiatric medication, heart medication, diabetes medication, or other prescriptions someone was already taking before the storm arrived.

That’s where the interaction question lives: between what you already take and what the disruption adds.

Under normal circumstances, several layers of the healthcare system help catch those potential problems. Your medical record contains your prescriptions. Your regular pharmacy knows what it has dispensed. Pharmacy software flags potential interactions. A pharmacist can review the combination before handing you the medication.

During a disruption, some of those layers may disappear. You may be using a different pharmacy, buying an over-the-counter medication somewhere that doesn’t have your prescription history, or receiving care from a clinician who has never seen you before.

The Emergency Can Change More Than Your Medication List

There’s another reason medication safety can become more complicated during a disaster: your body and circumstances may be different too.

You may be spending hours working outside in the heat, drinking less because clean water is limited, dealing with vomiting or diarrhea, or eating very differently than usual. At the same time, access to routine lab work, follow-up appointments, and medication monitoring may be interrupted.

A medication combination isn’t used in a vacuum. Your hydration, health conditions, and other medications all matter. That’s why a combination you’ve taken without problems under ordinary circumstances shouldn’t automatically be assumed to be problem-free when new medications and unusual physical stressors are added.

This doesn’t mean you need to understand every possible interaction yourself. It means the person helping you make a medication decision needs to see the whole picture.

Your Medication List Is Part of That Picture

We’ve said this before at Jase, but this is one more reason to keep a current written medication list. For each prescription, include the medication name, dose, prescriber, and pharmacy, and keep that information somewhere you can access even if your phone is dead, the patient portal isn’t loading, or you’re standing in a pharmacy that has never filled a prescription for you before.

That list isn’t only there to help you remember what you take. It gives a pharmacist or clinician the information they need to check what you’re about to add against what’s already there.

Your regular pharmacy computer may have been quietly helping catch these interactions for years. It can’t do that for you from a parking lot.

Ask Your Pharmacist One Question Before the Storm

The best time to discover an important medication interaction isn’t while you’re sick, evacuated, or trying to find an open pharmacy. The next time you have an appropriate opportunity to speak with your pharmacist, bring your current medication list and ask:

“If I end up needing an antibiotic or a pain reliever during an emergency, are there any of my regular medications that I need to be especially careful about combining with them?”

Then write down what they tell you somewhere you can find it during an emergency.

You don’t need to become your own pharmacist or memorize every possible combination. You simply want to know where the potential trouble spots are in your medication list so that, if normal systems aren’t available, you know when you need to stop and get professional guidance rather than guessing.

Appropriate Medical Preparation Includes What You Already Take

Emergency medical preparation often focuses on what you might need to add: wound supplies, contingency medications, pain relievers, cold medicine, or other essentials. But preparedness also means understanding how those things fit alongside the medications already keeping you healthy.

At Jase Medical, we’re a family team of medical doctors, PAs, and pharmacists focused on appropriate medical preparation—clinically grounded readiness for the moments when normal healthcare access becomes harder to reach. We’re not a replacement for primary care or your pharmacist. In fact, this is exactly why we want them in the conversation before you need the backup plan.

So before the next storm or disruption, read the active ingredients before combining medications, and ask your pharmacist which common additions could cause problems with the prescriptions you already take.

Because during an emergency, the safest medicine cabinet isn’t necessarily the one with the most medication in it. It’s the one where somebody has already checked how the pieces fit together.


The Jase Medical Team is a family team of medical doctors, PAs, and pharmacists focused on appropriate medical preparation: clinically grounded readiness that complements, rather than replaces, the healthcare professionals you already trust.

This article was prepared by the Jase Medical content team for informational purposes only and does not constitute medical advice. Prescription requirements, emergency dispensing rules, insurance coverage, and controlled-substance regulations vary by medication, jurisdiction, and individual circumstances. Consult a licensed healthcare provider or pharmacist regarding your specific medications.

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