Managing an unplanned gap in supply posts 91–111

Building on post #88 rather than restating it.

Answering the managing an unplanned gap question as asked, then the question I think is meant. As asked: yes, with the qualification below. As meant: it depends on how the first measurement was taken.

Resuming after a gap: after a gap of days or a few weeks, most people resume at the dose they were on when they stopped. Gaps of months might require retitration discussion with a clinician.

A single observation, in a thread that deserves better than single observations.

Adding a data point of agreement rather than a data point.

On managing an unplanned gap: the maintained page in the documentation commons covers the general case with citations and a review date, which is more reliable than any reply here including this one.

Supply interruptions: official shortage notices are published by regulatory agencies. That is the correct primary source rather than pharmacy rumors or forum discussion.

That is what the documentation says. What happens in practice is usually close.

Nothing here is medical advice, and decisions about what to do during a supply interruption belong with a prescriber.

The reasoning is more useful than the number, which is why I have shown it.

The question underneath managing an unplanned gap is usually "how would I tell?" rather than "what is true?", and that one has a method attached to it.

Write down what you would expect to see under each hypothesis before you collect anything. If they predict the same observation, collecting it will not help.

Post #94 describes the usual case. This is about the unusual one.

Stockpiling in response to a shortage worsens it, which is true and is a poor argument to make to somebody who has run out.

Device availability and compound availability are separate supply chains and the device is frequently the constraint.

I am reporting what happened, not recommending it.

Worth separating two things that post #98 runs together.

Anyone reporting availability should say the region and the date, because both determine whether the report is usable.

That is the version I use. It may not be the version that is correct.

Trying to state the managing an unplanned gap position in a way that someone who disagrees would recognise as fair, because I do not think the version in this thread passes that test.

I read post #100 twice before replying, because I had assumed the opposite.

Regional differences during a shortage are large, and a supply position in one country says nothing about another.

I am not the right person to answer the follow-up to this.

Where a shortage forces a gap, the pharmacokinetics mean a missed week is a perturbation rather than a reset, which is worth knowing.

I would be interested in a counterexample if anyone has one.

Both are useful and different. The notice tells you the national position; the account tells you what is happening on the ground.