Medication Therapy Management
What is Medication Therapy Management?
What It Is and Why It Matters?
Medication therapy management (MTM) is a patient-centered service provided by pharmacists to help patients manage their medications and improve their health outcomes. MTM services include comprehensive medication reviews, adherence counseling, medication-related problem identification and resolution, and medication optimization. MTM is especially important for patients with complex medication regimens or multiple chronic conditions, who are at risk of medication-related problems and adverse drug events.
Comprehensive Medication Review:
Evaluating the Safety and Efficacy of Medications A comprehensive medication review (CMR) is a systematic evaluation of a patient’s medication regimen by a pharmacist, with the goal of identifying and resolving medication-related problems. CMRs typically involve a review of the patient’s medical history, medication list, and laboratory results, as well as a discussion with the patient about their medication use and any concerns or questions they may have. CMRs can help identify potential drug interactions, duplicate therapies, inappropriate dosing, and other issues that may be impacting the patient’s health and well-being.
Polypharmacy:
Managing Multiple Medications and Conditions Polypharmacy is the use of multiple medications by a patient, often for the treatment of multiple chronic conditions. Polypharmacy can increase the risk of adverse drug events, drug interactions, and medication-related problems, especially if medications are not managed effectively. MTM services can help patients manage their medications and reduce the risks associated with polypharmacy, through careful monitoring, medication optimization, and patient education.
Adherence Counseling:
Supporting Patients in Taking Their Medications Adherence counseling is a key component of MTM, and involves working with patients to improve their medication adherence and ensure that they are taking their medications correctly and consistently. Adherence counseling may include medication reminders, education on proper medication use, and addressing any barriers to adherence that the patient may be experiencing. Improving adherence can help improve health outcomes and reduce healthcare costs associated with medication-related complications.
Medication-Related Problems:
Identifying and Resolving Issues with Medications Medication-related problems (MRPs) are issues that arise from the use of medications, and may include adverse drug events, drug interactions, inappropriate dosing, and medication non-adherence. MRPs can have serious implications for patient health and well-being, and can lead to hospitalization or other medical interventions. MTM services can help identify and resolve MRPs, through comprehensive medication reviews, medication reconciliation, and medication optimization.
Medication Optimization:
Improving Medication Use and Outcomes Medication optimization is the process of ensuring that patients are taking the right medications, at the right dose, for the right duration, and with the right monitoring. Medication optimization involves careful monitoring of patient response to medications, as well as adjustment of medications as needed to ensure optimal outcomes. MTM services can help patients achieve medication optimization by working closely with their healthcare providers to identify and resolve medication-related problems, and by providing patient education and support.
Chronic Disease Management:
Supporting Patients with Multiple Chronic Conditions Chronic disease management is a key focus of MTM services, as patients with chronic conditions often require multiple medications and complex medication regimens. MTM services can help patients manage their chronic conditions effectively by providing personalized medication plans, medication reconciliation, medication education, and adherence counseling. By improving medication use and adherence, MTM services can help patients achieve better health outcomes and reduce the risk of hospitalization and other medical interventions.
Who can utilize benefits of MTM?
Any patient who uses prescription and nonprescription medications, herbal products, or other dietary supplements could potentially benefit from the MTM core elements. As part of the effort to effectively address the urgent public health issue of medication-related morbidity and mortality, MTM services should be considered for any patient with actual or potential medication-related problems, regardless of the number of medications they use, their specific disease states, or their health plan coverage. Although the needs of individual patients may vary, the use of a consistent and recognizable framework for core MTM services, will enhance their efficient delivery and effective quality measurement.
Who Benefits from MTM
- Patient has experienced a transition of care, and his or her regimen has changed
- Patient is receiving care from more than one prescriber
- Patient is taking one or more chronic medications (including prescription and nonprescription medications, herbal products, and other dietary supplements)
- Patient has at least one chronic disease or chronic health condition (e.g., heart failure, diabetes, hypertension, hyperlipidemia, asthma, osteoporosis, depression, osteoarthritis, chronic obstructive pulmonary disease)
- Patient has laboratory values outside the normal range that could be caused by or may be improved with medication therapy
- Patient has demonstrated nonadherence (including underuse and overuse) to a medication regimen
- Patient has recently experienced an adverse event (medication or non–medication-related) while receiving care
- Patient is taking high-risk medication(s), (e.g., warfarin, phenytoin, methotrexate)
These services include but are not limited to the following, according to the individual needs of the patient:
- Performing or obtaining necessary assessments of the patient’s health status
- Formulating a medication treatment plan
- Selecting, initiating, modifying, or administering medication therapy
- Monitoring and evaluating the patient’s response to therapy, including safety and effectiveness
- Performing a comprehensive medication review to identify, resolve, and prevent medication-related problems, including adverse drug events
- Documenting the care delivered and communicating essential information to the patient’s other primary care providers
- Providing verbal education and training designed to enhance patient understanding and appropriate use of his/her medications.
- Providing information, support services, and resources designed to enhance patient adherence with his/her therapeutic regimens.
- Coordinating and integrating MTM services within the broader health care management services being provided to the patient.
Our MTM service model includes the following five core elements:
- Medication therapy review (MTR)
- Personal medication record (PMR)
- Medication-related action plan (MAP)
- Intervention and/or referral
- Documentation and follow-up
Every core element is integral to the provision of MTM; however, the sequence and delivery of the core elements may be modified to meet an individual patient’s needs. Pharmacists provide medication therapy management to help patients get the best benefits from their medications by actively managing drug therapy and by identifying, preventing and resolving medication-related problems.