The MTM Continuum

As pharmacy continues to shift from being pill and product-focused to serving as local healthcare professionals more deeply involved with patients at every level of the care process, it is playing an increasingly pivotal role in the state of our nation’s health, and more specifically, in how we address the rising issue of medication mistakes and mismanagement.

With nearly half of Americans experiencing chronic diseases and conditions, there has never been a greater need for pharmacists to be on the frontlines, ensuring that patients have the right kind of medication and care, at the right time. More chronic conditions means more people are taking medications, which means more risk for error. In fact, medication errors are on the rise, nearly doubling since 2000. Poison control centers log medication errors at a rate of one every 21 seconds, translating to at least 1.5 million medication errors across the U.S. each year. And that is just what’s been reported.

Undoubtedly, problems related to medication and its lack of management is a serious issue of our day. I think you know where I’m going with this: Let’s talk about medication therapy management (MTM). Officially, the term has only been around since 2004, but it’s already developed quite the reputation. What comes to mind at the mention of MTM? For most of us, it’s comprehensive medication reviews (CMR) and/or resolving medication related problems. However, that definition is actually far too narrow. In reality, MTM is a spectrum of services that support and optimize therapeutic outcomes for individual patients.

The MTM Spectrum

Going beyond medication reviews and immunizations, MTM is designed to help patients achieve their best outcomes through a range of services, all of which focus on preventing, identifying and resolving medication-related problems. So, what might this include? Well, it ranges from very simple actions like biometric monitoring (i.e. blood pressure reading, A1Cs) to more complex services like pharmacogenetic counseling. Ultimately, everything boils down to the pharmacist making sure that patients are on the right medications, in the right combinations, with the right doses, at the right time.

While some pharmacists question – or even doubt – their ability to conduct MTM, the truth is most are already performing at least some element of medication therapy management every day, with many unaware that they are even doing so. Case and point, one of my regular patients recently came in to buy an O.T.C. cough syrup – for the third time in a month! So, I asked her what was wrong, and she complained of a nagging cough. This prompted me to ask if she had recently started to take any new medication, and as it turns out, she had –  a new blood pressure medication that her doctor’s office sent to another pharmacy. Knowing that some ace inhibitors tend to cause a cough side effect, I asked her for the name of the medication. After learning that she was in fact prescribed to one of these such medications, I offered to call her doctor to ask about having her prescription changed to an ace inhibitor that treats high blood pressure, but that doesn’t produce a cough side effect. She delightedly said, “Yes, please.”

And that was MTM.

As the most accessible provider in a patient’s healthcare experience – and the only medication expert on the healthcare team – the pharmacist’s role has never been more crucial. I know many of you are interested in stepping up your MTM services, so please stay tuned for the next installation in this series where we will discuss how you can use the PrescribeWellness platform to dive into MTM and get paid for your clinical services.

The reality is that you’re probably already fulfilling elements of MTM each day, so it’s important to ask – what’s the next step to increase your offering along the MTM spectrum? Where could you help patients more in their efforts to get – and stay – healthy while also expanding your role as a true healthcare provider?

Want more? Learn how you can get FREE access to our PrescribeCare tool and get paid for enhanced services.



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