Medication Therapy Management, or MTM, is a set of distinct services that optimize therapeutic outcomes for individual patients. These services are independent of, but may occur in conjunction with, the provision of a medication product.
A comprehensive medication review (CMR) involves thoroughly evaluating your current medications, including prescriptions, over-the-counter drugs, and dietary and herbal supplements. The results help you understand your medications and develop a plan to improve your health.
Increased Medication Adherence
Medication nonadherence—when patients do not take their prescribed medications as instructed—is a serious problem that contributes to suboptimal outcomes, hospital readmissions, and billions in additional healthcare costs. Many factors can contribute to medication nonadherence, including poor physician-patient communication, drug side effects, and lack of education about a patient’s medications.
Pharmacy medication therapy management allows physicians and pharmacists to work with patients with multiple conditions, complex dosing schedules, and confusing medication instructions, often called polypharmacy. This collaborative care model improves the quality of patients’ therapeutic outcomes and decreases overall annual health expenditures.
MTM is based on the principle that medication adherence will increase when clinicians and their support staff conduct a thorough, accurate medication review and communicate effectively with patients about their regimens. This is accomplished by leveraging an evidence-based clinical tool, the four-item Morisky-Green-Levine Medication Assessment Questionnaire, which assesses patients’ self-reported adherence behavior via face-to-face interviews.
This standardized tool allows for one-on-one conversations and can uncover adherence issues, including forgetting or being careless about taking medicines, discontinuing medication when feeling better, and not understanding why they are being treated with certain drugs.
Better Symptom Management
Medication Therapy Management (MTM) is an important service that pharmacists provide to help optimize patient outcomes. The core MTM services include comprehensive medication reviews, targeted interventions, and ongoing medication monitoring.
These services help patients understand their medications, leading to better communication with healthcare providers. They also can help reduce side effects, which can cause or exacerbate a person’s symptoms.
Symptoms are an important indicator of medication effectiveness. The ability to better manage a patient’s symptoms helps improve the quality of life and reduces the cost of health care.
MTM is one example of how pharmacies can integrate their expertise into the healthcare system to support complex consumer needs. Recent data supports this point by demonstrating that these more complex consumers prefer their community pharmacy and often select it first over their health plan.
Reduced Risk of Adverse Events
Medications are an important part of treatment for many conditions but can also cause adverse events. Medication therapy management can help identify and address medication-related problems before they become serious.
MTM services include a comprehensive medication review (CMR) and regular, targeted follow-up sessions that offer one-on-one help with patients to ensure their medications are working as intended. The CMR identifies all prescription drugs, over-the-counter medicines, and dietary supplements to ensure all prescribed medications work together properly.
It is not enough to monitor the list of medications a patient takes; to avoid the consequences that can arise from non-optimized medication therapy, more must be done. A broad set of interventions is necessary to minimize the risk of adverse events, and MTM has proven to be effective at doing just that.
Reduced Hospital Readmissions
Hospital readmissions are costly for patients and healthcare systems, often occurring due to medication-related problems.
Medication therapy management can reduce these readmissions by ensuring that patients’ transition from hospital to home is smooth and that all medications are accurate, accessible, and easy to read.
One hospital-based MTM program began as a pilot and is now incorporated into the clinical pharmacist’s job description. The program includes comprehensive medication reviews, medication reconciliation, patient education, and faxing discharge prescriptions to pharmacies (including the community pharmacist) for refills.
The results of this study demonstrated that the MTM intervention significantly reduced readmissions compared to the control group. The MTM team identified numerous medication-related issues to be addressed and helped improve the clarity of the discharge instructions.
A recent study found that telepharmacy MTM post-discharge medication review was associated with reduced readmissions for Medicare beneficiaries recently discharged from a hospital diagnosed with congestive heart failure, chronic obstructive pulmonary disease, or pneumonia. This could be an important opportunity for independent community pharmacies to support hospital transition of care programs, lowering readmission rates and improving quality.
Improved Health Outcomes
A comprehensive medication review ensures that patients benefit most from their medications. It can reduce complications like side effects and drug interactions while also improving compliance and adherence. This ultimately allows patients to spend less time going back and forth with their physicians, reducing overall care costs.
Results from a recent study of MTM programs demonstrated that medication management interventions significantly improve outcomes, including clinical outcomes and cost savings.
Conclusion
The study found that MTM was associated with better medication appropriateness (measured using a validated 10-item measure of prescribing quality), improved adherence measured as a percentage of prescriptions filled, reduced number of medications dispensed and lowered costs, and lower frequency of medication-related problems and adverse events.
While the evidence is still limited, this research points to clear advantages of MTM services for payers and their customers. Moreover, the benefits of MTM are likely to increase as these services become more widespread in accountable-care organizations and patient-centered medical homes.
