Special FeatureMedication therapy management in pharmacy practice: Core elements of an MTM service model (version 2.0)
Section snippets
Framework for pharmacist-provided MTM services
This framework for MTM service delivery in pharmacy practice is designed to facilitate collaboration among the pharmacist, patient, physician, and other health care professionals to promote safe and effective medication use and achieve optimal patient outcomes. MTM services in all patient care settings should include structures supporting the establishment and maintenance of the patient–pharmacist relationship.
Providing MTM services in various patient care settings
Patients with a potential need for MTM services can be identified by the pharmacist, physician, or other health care professionals; the health plan; or patients themselves when medication-related problems are suspected. Appendix 4 provides considerations for identification of patients who may benefit from MTM services. Patients may be especially vulnerable to medication-related problems during transitions of care, such as when their health care setting changes, when they change physicians, or
The delivery of MTM services by the pharmacist
Within the MTM core elements service model, the patient receives an annual comprehensive medication therapy review and additional medication therapy reviews according to the patient's needs. The patient may require ongoing monitoring by the pharmacist to address new or recurring medication-related problems.
The total number of reviews required to successfully manage a patient's therapy will vary from patient to patient and will be ultimately determined by the complexity of the individual
Core elements of an MTM service model in pharmacy practice
The MTM service model in pharmacy practice includes the following five core elements:
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Medication therapy review (MTR)
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Personal medication record (PMR)
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Medication-related action plan (MAP)
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Intervention and/or referral
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Documentation and follow-up
These five core elements form a framework for the delivery of MTM services in pharmacy practice. 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
External communication of MTM documentation
Following documentation of the MTM encounter, appropriate external communication should be provided or sent to key audiences, including patients, physicians, and payers. Providing the patient with applicable documentation that he or she can easily understand is vital to facilitating active involvement in the care process. Documentation provided to the patient at the MTM encounter may include the PMR, MAP, and additional education materials. Documentation to physicians and other health care
Follow-up
When a patient's care setting changes (e.g., hospital admission, hospital to home, hospital to long-term care facility, home to long-term care facility), the pharmacist transitions the patient to another pharmacist in the patient's new care setting to facilitate continued MTM services. In these situations, the initial pharmacist providing MTM services participates cooperatively with the patient's new pharmacist provider to facilitate the coordinated transition of the patient, including the
Conclusion
The MTM core elements, as presented in this document, are intended to be applicable to patients in all care settings where the patients or their caregivers can be actively involved with managing their medication therapy, taking full advantage of the pharmacist's role as the “medication therapy expert.” Figure 3 presents a flow chart of the core elements of an MTM service model contained in this document. As the core elements service model continues to evolve to meet diverse patient needs,
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Developed through a joint initiative of the American Pharmacists Association and the National Association of Chain Drug Stores Foundation.
Disclosure: The organizations declare no conflicts of interest regarding products or services discussed in this manuscript. The authors declare no conflicts of interest or financial interests in any product or service mentioned in this article, including grants, employment, gifts, stock holdings, or honoraria.
Acknowledgments: Individuals and organizations participating in the review of this document are listed in Appendices 1 and 2.
Copyright © 2008, American Pharmacists Association, Inc., and the National Association of Chain Drug Stores Foundation, Inc. All rights reserved.