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Patient Medication Refill Policy

In order to help us take better care of your chronic and acute conditions, we have created this medication refill policy. This policy is in line with clinics across the country that are keeping closer tabs on their patients through the model of a “medical home”. Many medications can be refilled as long as you have had an annual (complete physical) exam or office visit addressing that problem within the last 3-12 months. For most chronic diseases there are guidelines that help us make sure that we are monitoring your chronic condition at appropriate intervals with office visits and lab work periodically. These include, but are not limited to the following:

Chronic condition recommended visit frequency:

  1. Depression/Anxiety: every 6-12 months
  2. Diabetes: every 3-6 months
  3. Hypertension: every 6 months
  4. Asthma: every 12 months
  5. Chronic pain: every 3 months

Here at Primary Medical your health is important to us and it is our goal to provide the best care possible for our patients.  As part of this goal, we need to make some changes for all Primary Medical patients and providers in regard to treatment with controlled medications.   We would like to keep all of our Primary Medical patients informed of our new policies, even if you are not taking any of these types of medications.

In the past few years there have been major changes in prescribing controlled medications across the United States.  Controlled medications, also known as Schedule 2 through 5, include narcotic medications or opiates, sleeping medications or sedatives, and stimulant medications.  Controlled medications have a risk of dependence and potential for abuse, are prone to long term side effects, and require careful monitoring.

At Primary Medical, we are following guidelines put forth by the CDC, the California Medical Board, the Drug Enforcement Agency and our Professional Medical Societies, for any patient receiving Schedule 2 through 4 medications for a duration of longer than 3 months. Schedule 2 through 4 medications include opiates, benzodiazepines and certain types of ADHD and insomnia medications.

  • We will be requiring office visits every 3 months to refill controlled medications

  • We will be performing random urine drug screening

  • We will be running a Controlled substance Utilization, Review and Evaluation System (CURES) report each time a refill is needed (this is mandated by a new state law – CURES is a database from the State of California that keeps track of all controlled medication prescriptions)

We will also be changing our previous 3-day (72 hour) policy to refill medications up to a 5-day (120 hour) policy for medication refills of these controlled medications due to the increased work of these new guidelines.

Over time, the medical community has learned that the risks of ongoing controlled medication use are worse than we used to think.  Many of these controlled medications can be replaced with much safer options.  To this end, our providers are strongly encouraged to discuss alternate treatment options, tapering/reducing and ultimately discontinuing these controlled medications when appropriate. Furthermore, we will strongly discourage initiating medications like narcotics for the long-term treatment of non-cancer pain or benzodiazepines for the long-term treatment of anxiety-related disorders.

Please know that all of our providers will treat you as an individual and to the best of our ability. Safe prescribing of controlled medications is an important change for health care providers, our valued patients and also the health of our community.

Chronic pain: We are eager to work with our chronic pain population to offer a multi-disciplinary approach to chronic pain moderation, which may include physical therapy, cognitive therapy, medications (which may or may not include narcotics), ancillary therapy (message/acupuncture/chiropractic), radiographic imaging.

We will be requiring office visits every 3 months at a minimum to make sure that our treatments are working for you. While we will not be able to completely resolve your chronic pain, we are focused on treatment to help make your pain more manageable so that you can continue to live with minimal interruptions of your daily life.

ADD/ADHD: If you are receiving prescriptions for stimulants like Ritalin or Adderall, we require an office visit every three months to monitor your response to treatment and make sure that these medications continue to work for you. Often, as people age, stimulants become less effective and alternative therapies can be considered.

Anxiety: Benzodiazepines have a risk of addiction and dependence and for this reason we are very careful about prescribing them for long-term treatment of anxiety. We require an appointment every three months to make sure that these continue to be an appropriate choice for your anxiety. Studies show that the risk of dependence increases as the dosage and the duration of treatment increases, but it can occur even when appropriate dosages are used continuously for three months. Additionally, if used on a continuous basis, these medications can actually make your anxiety worse. For this reason, it is important for us to monitor these medications closely and offer alternative therapies if you find yourself needing to use these medications on a daily basis.