Chronic Medication Management
Chronic medication management aligned with the South African Chronic Disease List, with in-rooms acute dispensing under Section 22A(15) licence, chronic scripts to your pharmacy or Medipost, and Discovery Care Programme enrolment for eligible Discovery Health members.
Provided by Dr Ethan Chellan and Dr Claudia Lakay, MBChB (Stellenbosch University).
What We Offer
Chronic Disease List (CDL) management
We manage chronic conditions on the South African Chronic Disease List, plus acute on-script management for non-CDL chronic conditions. The CDL is the statutory subset of Prescribed Minimum Benefits (PMBs) that medical schemes must cover for chronic medication. Common conditions we manage include diabetes, hypertension, hyperlipidaemia, asthma, hypothyroidism, epilepsy, and HIV.
In-rooms acute dispensing
Both Dr Ethan Chellan and Dr Claudia Lakay hold individual Section 22A(15) dispensing licences from the National Department of Health. From a set formulary of acute medications, we dispense at the consultation for short-course treatment: antibiotics, analgesia, asthma rescue therapy, antihistamines, and similar. This includes acute add-ons for patients on chronic medication, where we screen for interactions with your existing chronic regimen before dispensing. Chronic medication itself is collected from a pharmacy of your choice.
Chronic scripts to your pharmacy or Medipost
Your chronic script goes to a pharmacy of your choice, the same way most medical schemes prefer. If you would rather have it delivered, we have an active partnership with Medipost Pharmacy, who deliver nationwide, usually within 2 to 3 working days. Discovery Health and other major schemes typically cover Medipost dispensing fees on chronic medication.
Discovery Care Programmes
Discovery Health members with eligible CDL conditions can be enrolled directly during a consultation onto the relevant Care Programme: Diabetes, Cardio, HIV, or Mental Health. Both Dr Chellan and Dr Lakay are accredited Premier Plus practitioners. Enrolment unlocks scheme-funded benefits beyond standard chronic cover, including extended annual reviews and allied health access.
Repeat scripts and continuity of care
CDL conditions usually require a structured annual review and 6-monthly check-ins, with monthly or bi-monthly script renewal in between. We schedule these proactively rather than waiting for you to run out. Bloods are drawn at the practice when due. Bloods, blood pressure tracking, HbA1c, lipid panels, and other monitoring are coordinated with your repeat scripts to keep your file current.
See: Monthly bloods for chronic patients, general practice care, vitality screening, scripts and reviews via telehealth.
How chronic medication management works
For most chronic conditions, the workflow at the practice is structured around a yearly anchor visit and shorter check-ins between.
Initial chronic visit (60 minutes). Full history, examination, and a baseline workup. For a new diagnosis we run the relevant baseline bloods (HbA1c, lipogram, kidney function, thyroid, depending on the condition), record blood pressure properly, and start the conversation about treatment options. The first script is dispensed or sent to your chosen pharmacy at the same visit.
Six-monthly check-in (20 to 30 minutes). Brief clinical review, blood pressure or relevant vital signs, repeat bloods if due, medication review. Most stable patients have this as a quick in-person visit; some are appropriate for telehealth.
Annual review (45 to 60 minutes). Full annual review covering blood pressure trend, medication adherence, side-effects, lifestyle, baseline bloods refresh, cardiovascular risk recalculation, and (where indicated) annual ECG. Discovery Care Programme members get an extended annual review covered by the scheme.
Between visits. Repeat scripts are renewed proactively in the 2 weeks before they expire; you do not need to come in just to renew if your last review is current. Bloods are drawn at the practice when due. We track the cycle so you do not run out.
What to bring to your first chronic visit:
- Your current medication boxes or a written list with doses
- Any recent blood results, even if from another doctor
- Your medical aid card and chronic authorisation number if your scheme has issued one
- A list of allergies and any non-prescription medication or supplements you take regularly
Conditions we manage on the CDL
The South African Chronic Disease List is the statutory set of conditions medical schemes must cover for chronic medication. Both Dr Chellan and Dr Lakay manage CDL conditions across the practice; the patient sees the doctor they choose, not the condition-doctor.
Diabetes
Type 2 diabetes is one of the most common conditions in our chronic-care patient mix. We manage from prediabetes through to insulin-dependent type 2 diabetes, with HbA1c monitoring, lipogram, kidney function and microalbumin, retinopathy and foot screening referral cycles, and medication titration. Type 1 diabetes is co-managed with an endocrinologist where the patient already has one.
For more on the diabetes pathway in South Africa, see The Diabetes Epidemic in South Africa, Prediabetes: What It Means, and our patient-facing guide for the first six months on type 2 diabetes treatment.
Hypertension and cardiovascular risk
Blood pressure management at the practice covers diagnosis (correctly measured, not single-reading clinic numbers), staging, first-line medication, ongoing titration, and cardiovascular risk recalculation. Annual ECG is included for higher-risk cardiovascular patients.
For the practical detail, see our patient guides on understanding your blood pressure numbers and managing high blood pressure in a South African context.
Hyperlipidaemia
Cholesterol management as part of cardiovascular risk reduction, with statin therapy first-line where indicated, lipogram monitoring, and integration with the rest of the cardiovascular workup.
Asthma
Asthma management with current step-up therapy guidance, spirometry where useful (see our ECG and lung function service), inhaler technique review, and asthma action plan.
Mental health (depression, anxiety, ADHD)
Mental health on the CDL covers depression, anxiety disorders, and adult ADHD. Dr Chellan holds the FPD certification in Mental Health and leads the practice's mental health work. Most cases are managed at GP level; complex or treatment-resistant cases are referred for psychiatric input. See our depression treatment guide for South Africans and our mental health service page for the full picture.
HIV
HIV is on the CDL and is a chronic condition. Dr Chellan holds the Diploma in HIV Management (CMSA) and leads the practice's HIV care. ART, viral load monitoring, opportunistic infection screening, and Discovery Premier Plus HIV Network coordination are all part of routine HIV care here. The detail is on the HIV management service page.
Hypothyroidism, epilepsy, and other CDL conditions
Hypothyroidism (TSH-monitored thyroxine replacement), epilepsy (where the practice is the routine prescribing GP and a neurologist co-manages), and other CDL conditions including chronic obstructive pulmonary disease, gout, and rheumatoid arthritis are all managed within scope. Where a sub-specialty is needed (e.g., active gout management, complex epilepsy), we coordinate referral and continue the chronic prescribing role alongside specialist input.
Who performs this service
Both doctors hold individual Section 22A(15) dispensing licences and manage chronic medication across the practice. Patients see the doctor they choose, not the condition-doctor; both Dr Chellan and Dr Lakay manage CDL conditions in their day-to-day clinics.
Dr Ethan Chellan
MBChB (Stellenbosch University), Diploma in HIV Management (CMSA), Diploma in Child Health (CMSA), FPD Certification in Clinical Management of Mental Health, FPD Telemedicine. Leads HIV and mental health work at the practice; manages the full CDL across his patient panel. Read more about Dr Chellan.
Dr Claudia Lakay
MBChB (Stellenbosch University). Leads women's health and IV vitamin therapy; manages the full CDL across her patient panel including diabetes, hypertension, asthma, hypothyroidism, and other chronic conditions. Read more about Dr Lakay.
Frequently asked questions
Do I have to come in every month for my chronic script?
No. Most patients on stable chronic medication are reviewed every 6 months, with an annual deeper review. Repeat scripts are renewed proactively in the 2 weeks before they expire, so you do not need to book a visit just to renew. The schedule is structured around clinical reviews, not script administration.
Will my medical aid cover my chronic medication?
For Chronic Disease List conditions, yes. Medical aid schemes are required by regulation to cover chronic medication for the conditions on the CDL. Coverage of specific brands or formularies varies by scheme; we work within your scheme's formulary where possible. Reception confirms scheme cover at booking, and chronic authorisation numbers can be issued by your scheme either online or by phone.
What is the difference between in-rooms dispensing and a pharmacy?
In-rooms dispensing is for acute medications dispensed at the consultation: antibiotics, analgesia, asthma rescue, antihistamines, and similar short-course treatments. Both doctors hold individual Section 22A(15) dispensing licences from the National Department of Health. Chronic medication is dispensed at a pharmacy of your choice or delivered via Medipost; we do not stock chronic supplies in the rooms.
What is a Discovery Care Programme and how do I enrol?
Discovery Care Programmes (Diabetes, Cardio, HIV, Mental Health) are scheme-funded extended-management programmes for Discovery Health members with eligible chronic conditions. Both doctors are accredited Premier Plus practitioners and can enrol you directly during a consultation. Enrolment unlocks scheme-funded benefits beyond standard chronic cover, including extended annual reviews and allied health access. See our Discovery Care Programmes page at /medical-aid/discovery-care-programmes for the detail.
Can I do my chronic review by telehealth?
Yes, for most stable chronic patients. Telehealth is appropriate for medication review, results discussion, prescription renewal, and routine follow-up where physical examination is not required. The annual deeper review and any visit involving examination, vitals, or in-rooms tests is in-person. Reception will guide which type fits the visit at booking.
Can I have my chronic medication delivered?
Yes. We have an active partnership with Medipost Pharmacy, who deliver nationwide, usually within 2 to 3 working days. Discovery Health and other major schemes typically cover Medipost dispensing fees on chronic medication. If you would rather collect from a local pharmacy, we send your script there directly.
What happens if I run out of chronic medication before my next review?
Call reception and we will assess the situation. For short-notice script renewal where the last review is still current, the doctor can issue a renewal without an additional visit. If your review is overdue or there is a clinical question, we will fit you in for a brief telehealth or in-person visit before issuing the script. We track review cycles to prevent this from happening, but emergencies do come up.
I am new to the practice and want to transfer my chronic care here. What do I do?
Book an initial chronic visit (60 minutes). Bring your current medication and any recent results, and a list of any conditions you are being treated for. We take it from there: review, baseline bloods if needed, set up the prescribing schedule, and enrol you on any relevant Discovery Care Programme if applicable. There is no separate registration step.
For Discovery Health members specifically, see our Discovery Care Programmes page.
Book your chronic visit
Book online or call reception. New chronic patients should book a 60-minute initial visit; existing chronic patients book the appropriate review slot.
NeoHealth
Suite 12, Prince Vintcent Square
Gloucester Avenue, George Central, 6530
Western Cape, South Africa
Walking distance from Mediclinic George. Undercover parking available in Prince Vintcent Square.