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CommunityPharmacistsandMedicationTherapyManagement.docCommunity Pharmacists and Medication Therapy Management
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Medication therapy management (MTM) is a distinct service or group of services provided by health care providers, including pharmacists, to ensure the best therapeutic outcomes for patients. MTM includes five core elements: medication therapy review, a personal medication record, a medication-related action plan, intervention or referral, and documentation and follow-up.
Within the context of cardiovascular disease (CVD) prevention, MTM can include a broad range of services, often centering on the following:
· Identifying uncontrolled hypertension
· Educating patients on CVD and medication therapies
· Advising patients on health behaviors and lifestyle modifications for better health outcomes
MTM is especially effective for patients with multiple chronic conditions, complex medication therapies, high prescription costs, and multiple prescribers. MTM can be performed by pharmacists with or without a collaborative practice agreement (CPA), and it is a strategy that can be considered to straddle Domain 3 (health care system interventions) and Domain 4 (community-clinical links).
· Implementation Considerations
Strong evidence exists that the use of MTM by pharmacists is effective. Although the exact combination of MTM activities tends to vary between settings, studies examining MTM have generally found it to be effective and to have strong internal and external validity. MTM trials have been replicated in many different contexts with positive results. Implementation guidance on MTM is available from several sources, including the guidance provided under Medicare Part D.
MTM at Ohio Department of Health
In 2014, the Ohio Department of Health (ODH) teamed up with three Federally Qualified Health Center (FQHC) sites to assess the effect of MTM counseling sessions on patients with hypertension. This effort involved collaboration among the Ohio State University College of Pharmacy, Ohio Pharmacists Association, Ohio Association of Community Health Centers, and the Health Services Advisory Group. These partners helped plan and develop the assessment. Pharmacists administered MTM to 500 patients with hypertension who were receiving care at one of the three FQHC sites. After 6 months, assessments found that hypertension control had increased to 68.6% among these patients. There were key components related to the project’s achievement, which included maintaining relevant partnerships, implementing the pilot in one type of pharmacy setting, allowing FQHC sites to develop their own protocols for patient enrollment, using effective dissemination processes, and selecting data points that align with current pharmacy practices. Challenges included finding champions for the MTM model.
For more information: Jen Rodis, Assistant Dean for Outreach and Engagement Ohio State University College of Pharmacy Email: [email protected] Website: www.ohiochc.orgexternal icon
References
1. Viswanathan M, Kahwati L, Golin C, et al. Medication therapy management interventions in outpatient settings. JAMA Intern Med. 2015;175(1):76–87.
2. Theising KM, Fritschle TL, Scholfield AM, Hicks EL, Schymik ML. Implementation and clinical outcomes of an employer-sponsored, pharmacist-provided medication therapy management program. Pharmacotherapy. 2015;35(11):e159–e163.
3. Tsuyuki RT, Johnson JA, Teo KK, et al. A randomized trial of the effect of community pharmacist intervention on cholesterol risk management: the Study of Cardiovascular Risk Intervention by Pharmacists (SCRIP). Arch Intern Med. 2002;162(10):1149–1155.
4. Carter BL, Barnette DJ, Chrischilles E, Mazzotti GJ, Asali ZJ. Evaluation of hypertensive patients after care provided by community pharmacists in a rural setting. 1997;17(6):1274–1285.
5. Chabot I, Moisan J, Grégoire J-P, Milot A. Pharmacist intervention program for control of hypertension. Ann Pharmacother. 2003;37(9):1186–1193.
6. Cheema E, Sutcliffe P, Singer DRJ. The impact of interventions by pharmacists in community pharmacies on control of hypertension: a systematic review and meta-analysis of randomized controlled trials. Br J Clin Pharmacol. 2014;78(6):1238–1247.
7. Santschi V, Chiolero A, Colosimo AL, et al. Improving blood pressure control through pharmacist interventions: a meta-analysis of randomized controlled trials. J Am Heart Ass. 2014;3(2).
8. Ryan R, Santesso N, Lowe D, et al. Interventions to improve safe and effective medicines use by consumers: an overview of systematic reviews. Cochrane Database Syst Rev. 2014(4):CD007768.
9. Isetts B, Schondelmeyer S, Artz M, et al. Clinical and economic outcomes of medication therapy management services: the Minnesota experience. J Am Pharm Assoc. 2008;48:203–211.
10. Ramalho de Oliveira D, Brummel A, Miller D. Medication therapy management: 10 years of experience in a large integrated health care system. J Manag Care Pharm. 2010;16(3):185–195.
11. Wittayanukorn S, Westrick S, Hansen R, et al. Evaluation of medication therapy management services for patients with cardiovascular disease in a self-insured employer health plan. J Manag Care Pharm. 2013;19(5):385–395.
12. Centers for Medicare & Medicaid Services. Medication Therapy Management. https://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovContra/MTM.htmlexternal icon . Accessed February 21, 2017.
13. American Pharmacists Association. APhA MTM Central. Implementing MTM in Your Practice. https://portal.pharmacist.com/mtmexternal icon . Accessed February 21, 2017.
14. Agency of Healthcare Research and Quality. Improving Medication Management for Older Adult Clients. https://www.guideline.gov/ summaries/summary/37826/improving-medication-management-for-older-adult-clients?q=assisted+livingexternal icon . Accessed August 18, 2017.
15. Agency of Healthcare Research and Quality. Innovations in Medication Therapy Management. https://innovations.ahrq.gov/issues/2015/02/18/innovations-medication-therapy-managementexternal icon . Accessed February 21, 2017.
16. Centers for Disease Control and Prevention. The 6|18 Initiative: Accelerating Evidence into Action. https://www.cdc.gov/sixeighteen . Accessed February 1, 2017.
17. Million Hearts. Cardiovascular Health Medication Adherence: Action Steps for Public Health Practitioners. Atlanta, GA: Centers for Disease Control and Prevention and Centers for Medicare & Medicaid Services; 2016.
Page last reviewed: August 27, 2021
Content source: National Center for Chronic Disease Prevention and Health Promotion , Division for Heart Disease and Stroke Prevention
