From the Guidelines
Patients taking controlled medications like oxycodone or methadone should generally have face-to-face visits with their healthcare provider every 1-4 weeks when starting these medications or adjusting dosages, and at least every 3 months thereafter, as recommended by the CDC guideline for prescribing opioids for chronic pain 1. The frequency of face-to-face visits may vary based on individual circumstances, such as the patient's risk of opioid use disorder or overdose. Some key points to consider include:
- Initially, more frequent visits (every 1-4 weeks) are typically recommended when starting these medications or adjusting dosages, especially for patients taking ER/LA opioids or those with a history of substance use disorder 1.
- Once a patient is stable on their medication regimen, visits may be extended to every 3 months, but should be conducted in person and be performed by the prescribing clinician, with virtual visits allowed in certain circumstances 1.
- Patients with complex pain conditions, history of substance use disorder, or those on high doses (≥50 MME/day) may require more frequent monitoring, such as every 1-2 months 1.
- These regular visits allow providers to assess medication effectiveness, monitor for side effects, evaluate for signs of misuse or diversion, and adjust treatment plans as needed, using tools such as the PEG Assessment Scale or the COMM 1.
- State regulations and insurance requirements may also influence visit frequency, so patients should follow their provider's specific recommendations for their situation. It's worth noting that while the 2017 HIVMA of IDSA clinical practice guideline for the management of chronic pain in patients living with HIV suggests that more frequent and intensive monitoring should be considered for higher-risk patients, the CDC guideline provides more specific and evidence-based recommendations for the frequency of face-to-face visits 1.
From the Research
Face-to-Face Visits for Controlled Medications
- The frequency of face-to-face visits with a healthcare provider for patients taking controlled medications is not explicitly stated in the provided studies 2, 3, 4, 5, 6.
- However, studies suggest that regular interactions with healthcare professionals are important for promoting medication adherence and addressing potential issues with controlled medications 2, 3, 4.
- For patients receiving methadone maintenance treatment, psychosocial interventions such as cognitive-behavioral therapy and educational and behavioral counseling have been shown to be effective in reducing opioid-positive rates and promoting treatment adherence 3.
- The use of technology, such as automated dispensing cabinets and barcode medication administration, can also help improve the safety and monitoring of controlled medications in hospitals 5.
- Methadone maintenance treatment has been shown to be an effective and safe treatment for opioid addiction, and women in these programs may have unique needs and differences that should be addressed 6.
Recommended Frequency of Face-to-Face Visits
- While the studies do not provide a specific recommended frequency for face-to-face visits, they suggest that regular monitoring and interaction with healthcare professionals are important for patients taking controlled medications 2, 3, 4, 5, 6.
- The frequency of face-to-face visits may depend on individual patient needs and circumstances, and should be determined on a case-by-case basis.
- Healthcare providers should consider factors such as the patient's medical history, current health status, and potential risks associated with controlled medications when determining the frequency of face-to-face visits.