"Core Elements" of Medication Therapy Management

When the nation's pharmacists begin providing Medication Therapy Management (MTM) services to patients under the new Medicare drug benefit next year, they will have little guidance from federal health regulators to use in designing specific services eligible for reimbursement under the program.

The American Pharmacists Association (APhA) and the National Association of Chain Drug Stores (NACDS) are moving to fill that void with a new model "framework"that identifies 5 "core elements"for pharmacists to consider using when providing MTM services to patients.

Pharmacists who follow the model would provide the following basic MTM services to Medicare patients who have >1 chronic disease, take multiple medications, and incur high medication costs:

• A once-a-year comprehensive "Medication Therapy Review," during which the pharmacist and the patient examine all medications currently being used (including OTC drugs, herbal products, and dietary supplements) and the pharmacist provides counseling to optimize those therapies
• A "Personal Medication Record," prepared on the basis of that review, that lists all medications, strengths, and directions for each patient
• A "Medication Action Plan," offering the patient useful strategies to maximize the benefits of his or her medication therapy
• "Pharmacist Intervention"to address any medication-related problems and to refer patients to other health care professionals, if necessary
• "Documentation of Services and Follow-up"by the pharmacist to ensure that patients continue to benefit from their medication therapy

The APhA and the NACDS Foundation are planning to augment the new MTM model with a complete operations manual, forms, and MTM practice guidelines for pharmacists and other pharmacy personnel.

Mr. Rankin is a freelance medical writer.