The Value of The Value of Medication Therapy Medication Therapy
Management Management ServicesServices
Purpose of Medication Therapy Management
Services (MTMS)• To optimize therapeutic outcomes
• To decrease the likelihood of adverse events
• To enhance patient understanding and adherence
• To reduce overall healthcare spending
American Pharmacists Association
Definition of MTMS
• Services provided by a pharmacist that improve treatment outcomes for individual patients
• A professional service to promote the safe and effective use of medications
• A way to provide better care for patients– Promotes collaboration among the patient, the
pharmacist, and the patient’s other health care providers .
Bluml BM. Definition of medication therapy management: development of professionwide consensus. J Am Pharm Assoc. 2005;45:566–72
MTMS Activities• Assess patients’ health status
• Devise medication treatment plan
• Select, modify and administer medications
• Review current medications and identify drug-related problems
• Communicate care to other providers
• Provide patient education
• Refer patients for broader disease management services
APhA. Pharmacists Improving Care and Reducing Costs for Your Plan Participants. Available at: www.pharmacist.com
Components of the MTMS Core Elements Service
Model • Medication Therapy Review (MTR)
– a review of all medications including prescription, nonprescription, herbal products, and other dietary supplements
• Personal Medication Record (PMR)
• Medication-Related Action Plan (MAP) for the patient
• Intervention and/or Referral
• Documentation and Follow-Up
APhA. Pharmacists Improving Care and Reducing Costs for Your Plan Participants. Available at: www.pharmacist.com
Evaluate appropriateness, effectiveness, safety, and compliance with medications
Identify drug therapy problems
Experienced Decision M
aking
PractitionerM
edic
atio
n Ex
perie
nce Patient
Therapeutic Relationship
Philosophy of Practice
Social Obligation
Responsibility to identify, resolve, and prevent drug therapy problems
Patient-centered approach
Caring
Today’s wants and needs
Responsibility to participate in information sharing and decision making
ASSESSMENT
CARE PLAN Resolve drug therapy problems Establish goals of therapy Interventions
FOLLOW-UP Evaluate progress in meeting goals of
therapy Record actual patient outcomes Reassess new problems
Medication Therapy Management Process
MTM Pharmacist/Prescriber
Relationship
Medication Recommendations
• MTM pharmacists may make recommendations in several ways:– Directly to the patient
• Over-the-counter changes, general adherence tips, managing side effects
– Through the prescriber• Changes in prescription medications
– Directly to the patient under a collaborative practice agreements
• Allows pharmacists to make adjustments to prescription medications via protocol
Summary of evidence of Value of MTMS
• Economic
– Multiple studies have shown positive results on total health care costs, creating a positive return on investment
• Clinical
– Multiple studies have indicated improved in clinical outcomes, specifically in diabetes, asthma, hypertension and dyslipidemia
• Humanistic
– The Asheville project has demonstrated reduced employee sick days and increased productivity.
Fera T., Bluml BM, Ellis WM. JAPhA. 2009; 49(3): 383-391.Isetts, et al., J Am Pharm Assoc. 2008;48(2):203-211Bunting BA, Cranor CW. JAPhA. 2006; 46:133-147..
Cranor CW, Bunting BA, Christensen DB. J Am Pharm Assoc. 2003;43:173-84.
What’s in it for the payer?• MTMS results in decreased overall healthcare costs
– Prescription costs will likely increase, but this is compensated by an overall decrease in costs
• Pharmacists can provide MTMS as a member of the health care team and medical home model
• Increased member satisfaction
• Mechanisms for MTMS claims processing are well established through CPT codes
What’s in it for the patient?
• MTMS provides patients with improved health outcomes from optimizing medication use
– This includes decrease emergency department visits and hospitalizations
• Increased understanding of medications and disease management
• Improved quality of life
Summary• Medications are a standard in the care of chronic
diseases
• Pharmacist delivered Medication Therapy Management Services are well documented to decrease health care costs while increasing the quality of health care
