"Core Elements" of Medication Therapy Management

When the nation's pharmacistsbegin providing Medication TherapyManagement (MTM) services topatients under the new Medicare drugbenefit next year, they will have littleguidance from federal health regulatorsto use in designing specific serviceseligible for reimbursement under theprogram.

The American Pharmacists Association(APhA) and the National Associationof Chain Drug Stores (NACDS) aremoving to fill that void with a newmodel "framework"that identifies 5"core elements"for pharmacists toconsider using when providing MTMservices to patients.

Pharmacists who follow the modelwould provide the following basicMTM services to Medicare patientswho have >1 chronic disease, take multiplemedications, and incur high medicationcosts:

• A once-a-year comprehensive"Medication Therapy Review,"during which the pharmacist andthe patient examine all medicationscurrently being used (includingOTC drugs, herbal products,and dietary supplements) and thepharmacist provides counseling tooptimize those therapies
• A "Personal Medication Record,"prepared on the basis of thatreview, that lists all medications,strengths, and directions for eachpatient
• A "Medication Action Plan,"offering the patient useful strategiesto maximize the benefits ofhis or her medication therapy
• "Pharmacist Intervention"toaddress any medication-relatedproblems and to refer patients toother health care professionals, ifnecessary
• "Documentation of Services andFollow-up"by the pharmacist toensure that patients continue tobenefit from their medicationtherapy

The APhA and the NACDS Foundationare planning to augment the newMTM model with a complete operationsmanual, forms, and MTM practiceguidelines for pharmacists andother pharmacy personnel.

Mr. Rankin is a freelance medical writer.