I should have said no years ago when the person at the register kindly asked, “Would you like to sign up for auto-refill?” Smiling, I replied, “Sure!” and volunteered my information to be uploaded into their computer.
Back then, this seemed revolutionary. No more remembering to call every month before I was out of pills, no searching my medicine cabinet for the most recent prescription bottle to get the seven-digit number I needed to punch into the phone for a refill. Now I’d never run out of medication!
Years later, every drug I’m prescribed is auto-refilled—even short-term meds. I’ve tried to un-enroll but can’t recall my home phone number from 30 years ago. Instead, I suffer through interminable texts: “Pamela, your medication E is ready.” I appreciate their discretion, but sometimes I don’t know which drug they mean.
And if I don’t pick up a prescription, I receive a phone message: “Your medication will be held for pickup for three days.” The computer-generated voice chastises me, implying that I’m noncompliant. Silently, I apologize to the pharmacy techs working to fill and then reshelve my “prescription.”
As a physician, I find automation challenging at times. I appreciate it when patients bring their actual pill bottles to appointments, so I can see what they are really taking. Sometimes they have several bottles of the same drug—and I need to remind them that taking extra doses of certain medications can be fatal. Worse is when I’m unaware patients are taking duplicate doses, and I make clinical decisions without that knowledge.
I recall cleaning out my father’s medications after he died. How did he have so many bottles of the same medications? Some bottles had a black X or the words “DO NOT TAKE” scrawled across the label. Other bottles contained different-shaped pills. I suspected they were different brands of the same drug—how confusing!
Patients’ refill requests now come through their electronic medical record onto my computer. Dutifully I send, deny, or edit the refills. During office visits, patients may ask for refills, while the computer says they have more on file. Other patients’ medications appear to need refilling, but the patient says they have several bottles at home.
Gone are the days of illegible ink scrawled on a prescription pad, of dropping off a paper scrip at the pharmacy counter and returning a few hours later to get it. Medicine has made much progress. And many trade-offs.
Pamela Adelstein
Newton, Massachusetts
2 thoughts on “Medication Automation”
It’s all a hassle now: pharmacist shortages causing random closures, supply chain issues on generics, insurance saying “too soon” when we try to consolidate renewals.
I really appreciate this post — identified a common issue many of us face. Old medications linger in our medical records forever, and I, too, sometimes forget why I was prescribed something when reviewing meds with a new physician.
Then there’s this: no central database of the meds a person is currently taking. Last year, I was prescribed a powerful anti-nausea drug after a stay in a hospital while away on vacation. I hadn’t yet filled it, and I returned home after I was discharged. When my diagnosis was finally made, I was prescribed antimalarial medication along with a strong antibiotic. Fearing a bad reaction, I then went to fill the anti-nausea prescription at my local pharmacy. Luckily, this pharmacist was on top of things. He said he couldn’t fill it, because taking it while on the other two meds could be fatal.