Here’s a Pharmacist-Recommended Checklist for Medication Therapy Management Program Results
By Leslie Helou, PharmD, Vice President, Medication Strategies, MOBE
As seen in Employee Benefits News.
It’s been more than two decades since the term “Medication Therapy Management” or “MTM” first entered the health care landscape. Its goal was to leverage the role of pharmacists to optimize therapeutic outcomes and reduce unnecessary medical and prescription health care costs. Since the inception of MTM, patients are on more prescription drugs, prescribed by providers who have less time to spend with them. It’s clear that a close examination of individual prescription drug lists is more needed than ever before. Unfortunately, many MTM programs do only that—examine a patient’s prescriptions and counsel based on system-generated interactions and adherence. This simplified review inhibits the full potential of MTM, which can be more effective at improving outcomes and reducing costs to patients and employers when done holistically with a focus on the whole person and their lifestyle.
As a pharmacist with more than 20 years of experience, I’ve seen firsthand the many ways a holistic review of a patient’s medications can help when pharmacists have access to a patient’s medical records, review their lifestyle behaviors, and recommend changes while collaborating with the patient and their broader care team. Doing so can save money, improve health outcomes, and even save lives.
If you’re not seeing these results and are wondering how an MTM program can help, or how your existing program can be more effective, I’d recommend asking the following questions:
- Does the program encourage collaboration between the pharmacist, patient, and their health care team?
For MTM to be effective, pharmacists need access to collaborate directly with the patient, as well as their care team to determine if their medication protocol is appropriate, effective and safe. Due to our fragmented health care system, many patients receive care from multiple providers, specialists and facilities, along with disease-centric management and digital health programs, leading to limited or no communication between stakeholders as well as disjointed medical records. While electronic health records have improved communication between many of these stakeholders, it’s rare that a pharmacist is able to see a patient’s complete health history. Additionally, MTM requires collaboration from the patient’s employer and provider to share eligibility and participation information, as many patients are unaware that they qualify for, or how they would benefit from, MTM assistance.
- Does it include time for added follow up?
Providers are under-resourced and overscheduled, allowing limited time to interact with patients and other members of the care team. Pharmacists encounter the same challenges when faced with increased responsibilities and staffing levels that can’t meet demand. A practice like comprehensive MTM requires time to be done effectively and make an impact. Dedicating time to effectively assess a patient’s medications and provide needed check-ins to promote follow-through on the nuances of recommendations is critical—necessitating a shift away from volume-based MTM targets.
Additionally, it’s important to allocate time to find patients who are typically left out of MTM program recommendations—a process that can be made more effective than the current set of standard criteria with enhancements in machine learning and AI.
- Does it address a patient’s lifestyle factors?
Despite a patient’s frequent touchpoints within the health care system, they can feel lost or confused about how to manage their health, and the why and how to follow medication directions from their provider. As the Vice President of Medication Strategies for MOBE, I often talk about the “medication management gap.” We work to fill this gap by providing patients with one-to-one coaching that integrates all of the lifestyle and health factors that play a significant role in medication need, effectiveness, safety and overall successful use. Our pharmacists not only coordinate with our lifestyle guides, but directly with a patient’s care team to limit confusion. Sufficient time for direct and frequent patient and care team interaction has led to impressive results in both health outcomes and reductions in medical and pharmacy utilization, such as a 15% average reduction in prescription drug use among our population.
Pharmacists realize the significant potential MTM has to enhance health outcomes and reduce health care costs by optimizing medication use and leveraging lifestyle improvements to achieve health results. However, several obstacles common in our volume-driven health care system can hinder its effectiveness. Addressing these challenges requires a multi-faceted approach involving integrated health care systems, collaborative care teams, and increased time spent with patients to sustainably address lifestyle improvements. It also requires improved access to and delivery of comprehensive MTM programs.
By acknowledging and proactively tackling these limitations, other health care providers, employers, and policymakers can work alongside clinical pharmacists to enhance the impact of MTM programs, leading to improved patient health and reduced health care expenditures. Taking a closer look at MTM programs and what they offer can produce positive returns for your bottom line, and more importantly, the lives of your employees.
