Medication therapy management is a group of services used by pharmacists and other healthcare professionals aimed at creating optimal results for patients undergoing therapy. Another goal of medication therapy management or MTM is to reduce overall health care expenditures.
The formal definition of MTM was arrived at in 2005 through a medical profession-wide consensus. The definition reads: “MTM is a distinct service or group of services that optimize therapeutic outcomes for individual patients. MTM services are independent of, but can occur in conjunction with, the provision of a medication product.”
MTM includes activities for planning the therapy to be used with a patient, monitoring the therapy, communicating effectively with patients undergoing therapy, and integrating MTM with other healthcare services being provided to the patient.
Planning the specific therapy for a patient includes assessment of the patient’s health status and creating a medication treatment plan.
Monitoring the therapy includes administering the therapy in accordance with the plan and modifying it as needed, evaluating the response to the therapy with a focus on safety and effectiveness, and conducting medical reviews to prevent adverse drug reactions. This activity group also includes informing other primary care providers with essential information about the patient.
Communicating with patients is essential not only because it reassures the patient by keeping them knowledgeable, but it also ensures that they are aware of the direction of the therapy and that the patient does not do anything to compromise the therapeutic approach. This activity group includes educating and training the patient on the proper use of medications and support services to ensure adherence to the therapeutic regimen.
Even with such a comprehensive and thoughtful approach to patient care and therapeutic support, MTM has met with several challenges related to its integration with the traditional pharmacy workflow and the larger health care system.
Regarding MTS integration into the traditional pharmacy workflow, pharmacists are debating whether to integrate MTM in their dispensing workflow or to treat it as a separate consulting service. Difficulties in integrating MTM are directly related to personal characteristics such as inherent adaptability to new processes. Some pharmacists cite lack of personnel as a reason for failing to integrate and implement MTM, and studies have shown that implementing MTM necessitates an increase in technician hours.
Three specific but related solutions are suggested in order to resolve the workflow integration issue. The first is to develop a standardized approach to MTM. The second is to have a policy of offering MTM to all patients, and the third is to clearly define the roles and responsibilities of all personnel regarding the implementation of MTM.
Another issue with MTM adoption is the lack of effective integration of MTM with larger health care systems because of the “silo” structure. This “silo” structure creates a block by which those implementing MTM, such as pharmacists, have difficulty reaching out and working with other health care professionals. Another block is the lack of awareness of other professionals about the activities under MTM. For example, they may not be aware that pharmacists have expanded roles that go beyond dispensing.
Possible solutions for MTM integration with the larger health care system include the creation of interdisciplinary teams to defeat the “silo” structure, more opportunities for cultivation of formal and informal relationships between professionals engaged in MTM and professionals in the larger health care system, and the creation of an MTM information hub.
