Medication Therapy Management is a distinct service or group of services provided by licensed pharmacists that aim to optimize therapeutic outcomes for individual patients. MTM includes five core elements [1]:
- Medication Therapy Review: Conducting a medication therapy review entails systematically collecting patient-specific information, evaluating prescription and over-the-counter medications as well as herbal supplements to identify problems, arranging a prioritized list of medication-related problems, and setting a plan to resolve them.
- Personal Medication Record: The PMR is a comprehensive record of the patient’s medications (prescription and nonprescription medications, herbal supplements).
- Medication-Related Action Plan: The MAP lists actions for the patient to follow in process of self-management.
- Intervention and/or Referral: The pharmacist intervenes to address medication-related problems and refers the patient to a physician or other healthcare professional for problems that are outside of his/her scope of practice.
- Documentation and Follow-up: MTM services are documented, and a follow-up MTM visit is scheduled based on the patient’s medication-related needs, especially upon transitions of care.
Identified problems may include incorrect dose, frequency, or administration of medications, therapeutic duplication, unnecessary medications, and the need for medication(s) for an untreated or inappropriately managed condition. Appropriate resolution of medication-related problems requires collaboration between the patient, the pharmacist, and the patient’s physician or other healthcare professionals.
MTM is particularly beneficial and useful for patients with co-existing chronic conditions, polypharmacy, exorbitant prescription costs, and several providers. MTM has been shown to be effective for lowering blood pressure, LDL cholesterol and HbA1c, improving patient quality of life and medication compliance, and overall promoting the rational use of medications.[2] Giving patients greater access to their pharmacist leads to a more enduring and trustworthy pharmacist–patient relationship and increases patients’ autonomy and willingness to proactively participate in their own management.
As this April 7, World Health Day, is focused on universal health coverage, expanding the pharmacist’s role through MTM is likely to increase access to health care for underserved, low-income populations. It ensures everyone can obtain timely quality pharmacotherapeutic care, right in the heart of the community. Thus, pharmacists assume a pivotal role in primary health care, empower individuals to take charge of their own health, coordinate care and advocate for their patients’ needs.
Discussion:
Do pharmacists provide MTM services in your country? What are barriers/advantages to implementation of MTM?
References:
1- American Pharmacists Association, National Association of Chain Drug Stores Foundation. Medication therapy management in pharmacy practice: core elements of an MTM service model (version 2.0). Journal of the American Pharmacists Association : JAPhA. https://www.ncbi.nlm.nih.gov/pubmed/18595820. Published 2008
2- Community Pharmacists and Medication Therapy Management | CDC | DHDSP. Centers for Disease Control and Prevention. https://www.cdc.gov/dhdsp/pubs/guides/best-practices/pharmacist-mtm.htm
