MTM – West Wichita Family Pharmacy

Medication Therapy Management (MTM)

Our MTM service is conducted via appointment or walk-in and connects you and your doctor with our specially-trained pharmacists to ensure all of your medications are safe, effective, appropriate, and optimized. MTM encompasses a broad range of services within the scope of a Pharmacist; beginning with a short introductory visit (telephone or in-person) to review all of your medications, followed by regular appointments to monitor your ongoing treatment plan

What is MTM?

MTM services are distinct from medication dispensing and focus on a service- & patient-centered, rather than a product-centered, process of care. These services encompass the proactive assessment and evaluation of a patient's complete medication regimen, rather than focusing on an individual medication product or reacting to medication changes and side effects

Courtesy of APhA

Program Elements

Assessment
Evaluation
Treatment Plan
Follow-Up
Documentation

MTM is Service-Based, Patient-Centered, & Proactive!

Rationale for MTM

Medication Therapy Management is recognized as a major way to help address some of the pervasive problems in the healthcare delivery system, including spiraling costs, medication errors, inappropriate prescribing, and non-adherence

Inappropriate use of medications contributes to more than 1.5 million preventable, medication-related adverse events each year. Pharmacist-led MTM provides an important service that fills patient education gaps, fosters proactive communication with other healthcare providers, and empowers patients to optimize medication use for improved healthcare outcomes.

Core Elements of an MTM Service

A growing trend in pharmacy is the pharmacy setting where the sole "product" is the medication & health management knowledge that the PharmD can impart to the patient one-on-one; Some fitting care services that are amenable to MTM include:

-Wellness Initiatives (e.g. smoking cessation)
-Travel Health Programs
-Pharmacogenetic Testing
-Transitions of Care
-Immunizations
-Disease State Education

APhA's MTM Digest- The Value of an MTM Service

A 2013 report published by IMS Health concluded that the U.S. health care system incurs costs of more than $200 billion due to inappropriate use of medications. These costs account for an estimated 10 milion avoidable hospital admissions, 78 million outpatient treatments, 246 million prescriptions, and 4 million ED visits, & constitute 8% of total annual health care expenditures.

Data shows that MTM service development is helping pharmacists become more integrated with their patients and the overall heathcare team by:

-Building lasting, trustworthy relationships with patients
-Obtaining a new level of respect with patients
-Building professionalism
-Creating opportunities for collaboration
-Increasing patient-provider-pharmacist interaction & centralizing associated patient documentation
-Increasing patient loyalty through more personal, hands-on care
-Being able to identify and resolve problems before they occur

How We Can Help

We will evaluate the clinical appropriateness of your medication regimen (including dosage & dosing regimen), and look for ways to reduce medication-related side effects, prevent harmful drug interactions, and lower drug costs
Each participant will receive an individualized care plan for his/her regimen that includes a plan for resolving each medication-related problem
A face-to-face interaction optimizes our pharmacists' ability to observe signs of- and visual cues to the patient's health, which can lead to early detection of medication-related problems
Monthly (or Quarterly) follow-up allows us to stay connected with & helps empower our clinic patients to self-manage their chronic conditions in conjunction with the West Wichita team
In addition, our Pharmacists are trained to supply patients with both disease state and lifestyle education. This includes the teaching of proper medication delivery- & monitoring device use
MTM is also a vehicle to deliver coaching & information to help empower our patients to self-manage their medications
MTM is an EXTRA service offered at no additional cost for eligible patients. It can benefit ALL pharmacy clinic patients in helping achieve health goals, stay adherent to medicines, and avoid adverse events
Our pharmacists will work with you, your physician(s), and/or other healthcare professionals to determine appropriate interventions to medication-related problems and how to best monitor your response to therapy

Patient Care Process

Collection of information for MTM involves a combination of obtaining info from the patient's medical records, obtaining info directly from the patient, and communicating relevant information to other providers.

An overarching goal of MTM being to connect these information sources, so that patients understand what has been prescribed & how to appropriately take it, and the prescriber recognizes how the patient is using medical therapies

MTM vs Rx Counseling

With MTM, the idea is to find out what the patient's goals are and to look for ways to address those needs or problems; this is achieved during regular appointments by asking the patient two basic questions:

If there is one issue we can address related to your medicines, what would it be?
What is the most important thing you want to get out of your visit today?

Why is MTM Worth My Time?

MTM is a valuable service for most (if not all) of the pharmacy clinic patients, if willing to actively participate:

Proven effective in helping patients better manage their health
Different (service-based & patient-centered) from traditional pharmacist counseling
Designed to focus on the individual patient's chief concerns, problems, and/or questions
Designed to streamline & simplify the individual's treatment, rather than complicate or create more work for the patient
Improves outcomes of drug therapy

The First Steps

For both you and the WWFRx pharmacists, an essential first step is establishing a patient-pharmacist relationship that supports engagement and effective communication with you (and any of your caregivers & providers)

This line of communication is maintained throughout the course of the MTM service, in conjunction with all involved providers, in order to centralize and simplify your medical information

Source: JCPP

MTM Goals and Impact

MTM services may contribute to medication error prevention, result in improved reliability of healthcare delivery, and enable patients to take an active role in medication & healthcare self-management
According to research conducted for NCPA, patients who participate in MTM / Medication Synchronization programs average more than 100 additional days on therapy per year and are 30% more likely to take their medication as prescribed
MTM has the ability to decrease number of patient trips to the pharmacy and his/her physician, and to minimize the number of outreach attempts needed to authorize your medications
Ability to proactively identify recent hospitalizations, doctor visits, and changes to each patient's medication therapy
Medicare expanded MTM services in 2003 and identified the following goals: (1) educate and counsel to improve patient understanding of their medications, (2) improve adherence, and (3) detect adverse drug reactions and improper medication use.

Re-defining MTM in the Post-health Reform Era

Lexicomp: Clinical Drug Information

"The findings pointed to favorable outcomes for clinical goals; humanistic outcomes, such as quality of life, patient satisfaction and reduced sick days; and a cost benefit ROI of 4:1 to 12:1."

Pharmacist,Abrams & Clark Pharmacy

"Everybody is a winner. The greatest savings for the pharmacy, for the patients, and for the overall health care system will be achieved from adherence to drug therapy resulting in improved disease management, reduced hospitalizations and fewer physician visits."

Med. Care. Journal Team-Based Care

"A team-based MTM program piloted in Minnesota (2012) utilized Pharmacists as part of the healthcare team in order to improve clinical outcomes across a study population of Diabetes patients. The study found that the MTM program improved treatment goals for diabetic patients by 22% versus sites that did not use team-based care."