HealthTap Medical Group Prescribing Guidelines

HealthTap Medical Group Prescribing Guidelines

Updated April 27, 2021

HealthTap’s formulary and prescribing guidelines enable doctors to prescribe appropriate medications after a virtual visit.

Some medications are restricted and not available for prescribing on HealthTap: 

• DEA-scheduled medications
• Anti-neoplastics
• Anti-psychotics
• Most injectables

NOTE: DEA-scheduled drugs are not found in the HealthTap prescription tool. Non-scheduled drugs that are restricted are found in the tool but labelled as "restricted" and not available for prescribing. 

• DEA Exempt “scheduled” items are restricted except for Donnatal 
• Anti-neoplastics are restricted except for topical varieties of - tretinoin, isotretinoin, or fluorouracil
• Anti-convulsants: gabapentin is restricted
• Anti-manics: lithium is restricted
• Contraceptives: all implants, IUDs and injectables are restricted
• Lifestyle medications: smoking cessation – varenicline (Chantix) is restricted, prescription weight loss drugs are restricted
• Most injectables are restricted, except:
• Common self-injectables: epinephrine, insulin, glucagon, naloxone, sumatriptan (Imitrex)
• Injections given by pharmacists: PPD TB test, selected vaccines

Caution: "Refill-only" and "Commonly abused prescriptions"

HealthTap guidelines encourage caution for certain drugs. Some non-narcotic medications are commonly abused and should be prescribed with great care, and such patients should be referred to the Virtual Primary Care clinic for followup and any future refills. (For example, muscle relaxants and promethazine cough syrup). 

Other medications are "Refill-only"; they are inappropriate to initiate after a single virtual urgent care visit, but may be appropriately refilled if the patient is already on the medication and doing well (for example, a patient taking antihypertensives with good control and no side effects). Patients who will need repeated refills for a chronic medication should be referred for followup care in the Virtual Primary Care clinic or to an in-person PCP (see the section below on "Refill-only")

Requirements for SOAP note documentation when prescribing "Refill-only" medications

• Name of the condition being treated and duration of treatment
• Patient response to treatment and any side effects
• Name of the originally prescribing doctor (ideally including the doctor's address)
• Referral for future refills (either to Virtual Primary Care clinic or to a patient's in-person PCP)

Refill-only medications (may start a new prescription in the Virtual Primary Care clinic and follow-up in the Virtual Primary Care clinic)

• Anti-coagulants and anti-platelet drugs
• Anti-arrhythmics (including digoxin)
• Anti-convulsants (except note: gabapentin is restricted)
• Non DEA-scheduled anti-ADHD medications: atomoxetine, guanfacine, or clonidine
• Anti-depressants
• Antihypertensives
• Contraceptives: birth control pills, patches, rings
• Antidiabetic medications
• Lifestyle medications category
• Erectile dysfunction medications
• Hair loss medications
• Smoking cessation medications– buproprion (Zyban)
• Substance abuse medications – oral naltrexone

Requirements for SOAP note documentation when prescribing commonly abused prescriptions (CAP)

• Name of the condition being treated
• Prescribe only the amount needed for a defined interval, with no refills
• Refer for future refills (either to the Virtual Primary Care clinic or to a patient's in-person PCP)

• Promethazine – (Phenergan)
• Propylhexedrine – (Benzedrex)
• Dextromethorphan and pseudoephedrine
• Muscle relaxants:
  • carisoprodol
  • chlorzoxazone
  • cyclobenzaprine
  • metaxalone
  • methocarbamol
  • orphenadrine
  • tizanidine
  • clonidine