Getting Your Medicine When Disaster Strikes

Zara M Risoldi, PharmD Candidate 2008
Shenandoah University
Prepared during Consumer Health Information Corporation Clerkship
McLean, VA

In Case of Emergency

If you were to flee your home in the midst of a natural disaster, what would you think to grab? Photo albums, jewelry and cash, the family dog? Would your prescription drugs make the list?

With little time for evacuees to prepare, life-saving medications can often be left behind. You might not know the name or exact dose of all your medications. Your paper medical records can be lost to flooding, fire, or other catastrophes. You need your prescription drugs in order to keep your medical conditions under control. Without the prescription number or other information, it is very difficult for you to get refills. You cannot just walk into any pharmacy and ask for your medicine, because they won’t know what you are taking.

That is the challenge that faced patients in September 2005, when Hurricane Katrina struck the Gulf Coast. Thousands of Americans were forced from their homes by storms and flooding without their prescription drugs. A survey was done at a New Orleans hospital following Katrina. Ten percent of patients did not take any medication with them when they evacuated. Another thirty-two percent did not take enough medicine with them and quickly ran out.

One Louisiana nurse wrote about her patients after the hurricane hit and said: “Most…included patients who had diabetes without medication, people with hypertension and no blood pressure medication, and mental health patients who had not taken medication in days.” After missing doses of their medications, these people’s lives were in danger.

A Quick Response from the Medical Community

The healthcare community quickly recognized and responded to the crises created when people couldn’t get their medicine. Medical and pharmacy groups banded together to help hurricane victims get their medicine. Within three weeks, KatrinaHealth.org was launched. This secure website gave doctors and pharmacists access to evacuees’ healthcare records. For months following the storm, it was used to fill refills and write new prescriptions for people who had lost their medical records.

KatrinaHealth.org was only a temporary database. Authorities realized that disaster can strike at any time, and a permanent solution was needed.

A Lasting Solution

The In Case of Emergency Prescription Database (ICERx.org) was launched in June 2007. It is a permanent database with features similar to KatrinaHealth.org. ICERx.org is ready to serve the country in case of future disasters.

The website is a collaboration between the American Medical Association, the National Association of Chain Drug Stores, SureScripts, and the National Community Pharmacists Association, as well as other healthcare groups. All of these partners are donating their time and resources to keep patients’ prescription records safe during an emergency.

Though healthcare providers have been able to register on the website since June, ICERx.org was “activated”, or turned on, for the first time in October. This was in response to the southern California wildfires.

What Can ICERx.org Do?

In order for pharmacists to dispense refills of any drug, they must have a complete record of the prescription information. ICERx.org stores all of the necessary information during emergencies, including:

Drug name
Dosage
Number prescribed
Your doctor’s name
Name of the pharmacy that you visited

ICERx.org also allows doctors to review your information when authorizing refills or prescribing new drugs during disasters. The database provides drug information and alerts that reduce the likelihood of drug interactions.

It does not matter what state you have evacuated to, or where you are seeking care. ICERx.org users can search for your information from anywhere in the country by using your home zip code.

Where Does ICERx.org Get Information?
Prescription data comes from electronic prescriptions sent by doctors to pharmacists on a network run by SureScripts, community pharmacies, state Medicaid programs and insurance groups. The majority of chain pharmacies, including CVS and Wal-Mart, contribute information to the site.

ICERx.org does not yet include data for every person in the United States. It is estimated that the database currently contains information for 70-75% of all Americans.

Unfortunately, there is no easy way to find out if your information is on ICERx.org. The decision to report information comes from corporate offices, not individual pharmacies. The National Association of Chain Drug Stores hopes to compile a list of companies who report to ICERx.org.

Private & Confidential

Healthcare providers can only access information during periods of a declared emergency which forces people to abandon their homes. Examples include hurricanes, earthquakes, or terrorist attacks.

You do not need to give your permission for your information to be recorded in the emergency prescription database. All information is carefully protected. The ICERx.org website has several features designed to keep your health information secure. Some medical conditions are very personal. Drugs for HIV/AIDS, mental health disorders, and substance abuse problems will never be displayed on ICERx.org.

Doctors and pharmacists must register on the site before they can view any records. Only those health professionals with up-to-date licenses in the United States are allowed to join. Careful records are kept of the health professionals who use the site. No one can make any changes to the information.

ICERx.org uses zip codes to display only the right information. Your prescription data will never be displayed if your home address is not part of the disaster area.

What Can You Do?

Unfortunately, there is no agreement on how patients should prepare their medications for emergency. The Department of Homeland Security and the American Red Cross recommend keeping a 7 to 14 day supply of all your medications as part of your emergency kit. They do not, however, offer any suggestions on how you should get or store these medications. You need to keep several things in mind:

Insurance plans will not pay for extra medication. You must pay out of pocket if you want an emergency supply.
Some people skip doses of their medication in order to create an extra supply of drugs. Skipping doses is not safe. You need the exact amount of medicine prescribed by your doctor to keep you healthy.
If you store an extra supply of your medicine in your emergency kit, it could go out of date before you need it. Be sure to check expiration dates often if you are keeping prescription or over-the-counter drugs in your emergency kit.
An alternative is to carry your prescriptions with you at all times. This is very impractical. You cannot carry medicines that need to be refrigerated (such as insulin) or that have other special storage needs. Do not store medications in your car’s glove box. Your car gets too hot in the summer and too cold in the winter, which can change how your drugs work.

There are some practical ways to prepare in case of a disaster. Here are some suggestions that anyone can do to make sure they have their medicine in an emergency situation:

Keep copies of your prescriptions in your wallet or emergency kit. Although pharmacists cannot fill photocopies of prescriptions, they can be used to get information about your medicines and your doctor.
Put a note on your emergency kit or checklist that will remind to get your medications before evacuating. Consider storing your emergency kit near your prescription drugs so you will not forget.

Once you reach safety, visit the nearest pharmacy as soon as you can. Tell the pharmacist to use ICERx.org. They will ask for your full name, date of birth, zip code, and sex (male or female).

When you are going on vacation, you have plenty of time to manage your medications and get your refills. There is no way of knowing when a disaster will occur, so you do not have that time to plan. Hopefully, you will never be caught in an emergency situation. If you are, it is best to be prepared By taking a few simple steps now, you can safeguard your medicine and protect your health when disaster strikes.



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