Abstract

Background: Direct-to-consumer (DTC) prescribed emergency medication kits provide households with a set of pre-prescribed medications for future use, but no real-world utilization data on this product category have been published.

Methods: We conducted a cross-sectional online survey of verified purchasers of an eight-medication prescribed kit (506 respondents). We describe utilization, self-reported outcomes among intended-use episodes (medication taken by the prescribed recipient), safety signals, free-text themes, and rural–urban distribution. Proportions carry 95% Wilson confidence intervals.

Results: Respondents were predominantly older adults (mean age 65.1 years; 77% aged 60 or over), and 75% resided in metropolitan ZIP codes. Of 506 respondents, 487 (96.4% of the 505 answering) had opened the kit and 364 (71.9%) had used it at least once. Repeat use was common, with 143 (28.3%) using it three or more times, and 114/367 (31.1%) of use-reporting respondents used it while traveling or in a remote setting. Among respondents describing a specific episode, the time from kit receipt to that use was within one month for 17 (4.6%), within three months for 82 (22.3%), within six months for 110 (30.0%), within one year for 120 (32.7%), and more than one year for 38 (10.4%). Respiratory illness accounted for 218/367 (59.4%) of described episodes. Among 333 intended-use episodes, 81.6% (95% CI 77.1–85.4) reported meaningful improvement within three days, 51.8% (46.4–57.1) perceived a reduced need for urgent care or the emergency department, and 86.1% (82.0–89.4) avoided clinic, urgent care, or hospital visitation. Overall self-reported net benefit was 95.8% (318/332; 95% CI 93.0–97.5; any positive perceived difference: reduced urgent-care/ED need, reduced disruption, or helped manage until care was available). Care escalation within 7 days occurred after 20/368 use-reporting respondents’ episodes (5.4%). Side effects were reported in 8/332 intended-use episodes (2.4%), all mild.

Conclusions: In the first real-world data on DTC emergency medication kits with pre-prescribed medications, respondents reported high engagement, frequent use for common acute illness, rapid symptom resolution, infrequent and mild side effects, and preparedness benefits extending even to never-users. These findings suggest that pre-prescribed emergency medication kits may represent a practical model for improving timely access to treatment and guided self-management of common acute illness when conventional access is limited or inconvenient. Large prospective, randomized trials are warranted in willing populations at risk for common illnesses covered in the kits.