IPC Final exam - MTM Flashcards
How can you help a patient manage multiple medications?
Medication Therapy Management definition
Medication therapy management, also referred to as MTM, is a term used to describe a broad range of health care services provided by pharmacists, the medication experts on the health care team.
History of MTM
Medicare Prescription Drug, Improvement and Modernization Act of 2003
- which Brought about Medicare Part D
- each part D sponsor is required to include MTM
What?
These services include but are not limited to the following, according to the individual needs of the patient:
Performing or obtaining necessary assessments of the patient’s health status
Formulating a medication treatment plan
Selecting, initiating, modifying, or administering medication therapy
Monitoring and evaluating the patient’s response to therapy, including safety and effectiveness
Performing a comprehensive medication review to identify, resolve, and prevent medication-related problems, including adverse drug events - meat and potatoes of it all
What?
Documenting the care delivered and communicating essential information to the patient’s other primary care providers
Providing verbal education and training designed to enhance patient understanding and appropriate use of his/her medications
Providing information, support services, and resources designed to enhance patient adherence with his/her therapeutic regimens
Coordinating and integrating medication therapy management services within the broader health care management services being provided to the patient
Why?
Why is medication therapy management needed?
Why is medication therapy management needed?
Medication-related problems and medication mismanagement are a massive public health problems in the United States.
Experts estimate that 1.5 million preventable adverse events occur each year that result in $177 billion in injury and death.
As many as450,000 adults aged65 and older visit the emergency room due to adverse drug events(ADEs) annually - that’s crazy
deprescribing -
Where?
Where is medication therapy management provided?
- Pharmacists provide medication therapy management services in all care settings in which patients take medications.
Who?
Who can benefit from medication therapy management?
Anyone who uses prescription medications, non-prescription medications, herbals, or other dietary supplements can benefit from this
People who may benefit the most:
- use several medications
- have several health conditions
- have questions or problems with their medications
- are taking medications that require close monitoring
- have been hospitalized because hospital meds are different. So much room for error
- obtain their medications from more than one pharmacy. Could be due to getting it cheaper. Patients are the keeper of the meds
Medicare-aged patients are the most frequent recipients of MTM services to manage their health.
Core Elements of MTM
Medication Therapy Review
- Collection of patient-specific information
- Assessment of medication therapies
- Identification of medication-related problems (MRP)
- Prioritization of MRPs
- Plan to resolve MRPs
Personal Medication Record
Medication-related action plan
Intervention and/or referral
Documentation and follow-up
Medication Therapy Review - like a “check-up” on their meds
Collection of patient-specific information
- allergies
- health conditions
- how they are feeling
- age
- weight
- diet
Assessment of medication therapies
- tell me why you are taking the med
Identification of medication-related problems (MRP)
Prioritization of MRPs
- which problem is the most important right now
Plan to resolve MRPs
Collection of patient-specific information
Collection of patient-specific information
carry a list of meds/drug cards
Medication-Related Problems
Indication:
Unnecessary drug therapy - they are on a med but they do not have an indication for it, maybe they did in the past but not today.
Additional drug therapy needed
Or there is an indication but no medication
Effectiveness: how well is it working
Wrong drug
Inappropriate dosage - maybe it is too low or too high
Safety:
Adverse drug effect - you do not always have to deal with the side effects. Make sure that they are not suffering due to the med
Inappropriate dosage
Adherence:
Inappropriate adherence
- never picked up med
- is their disease state under control
- lab values
- they may take it home but never actually take it
- ask (to make sure they take their meds) “Do you find it hard to remember to take meds” “tell me more about how you take your meds”
MEDICATION‐RELATED PROBLEM PRIORITIZATION LIST
Medication-Related Problem
Details
Priority
(Low, Medium, High)
outcome
Personal Medication Record
Comprehensive list of all medications
- Prescription
- Non-prescription
- Herbal
- Dietary products
Tool for self-management of medications
