Pharmacy students can play an integral role in medication therapy management (MTM) services.

Teaching students the core concepts through their didactic training can help prepare them for clinical rotations.

As part of its standards, the Accreditation Council for Pharmacy Education for the PharmD program emphasizes the importance of pharmacy students possessing MTM competence and knowledge to be successful on clinical rotations.1 Pharmacy students can also be integrated into MTM services through telehealth during the coronavirus disease 2019 (COVID-19) pandemic.

INTEGRATION INTO THE CURRICULUM

One study examined a program designed by Belmont University College of Pharmacy in Nashville, Tennessee, which used the American Pharmacists Association certificate training program to teach MTM concepts to third-year pharmacy students.2 The study results showed that students had an overall success rate of 93% on all 3 of the course assessments.2 Implementing the education program was beneficial for pharmacy students by improving their perceived competence, confidence, and readiness to perform MTM services.2

In 2012, the American Pharmacists Association MTM in the Curricula Expert Panel established recommendations describing how programs should be incorporated into pharmacy schools.3 These recommendations emphasize the importance of introducing the concept of MTM early in the curriculum. Active learning experiences, such as cases and virtual activ- ities, can help to prepare students for MTM clinical rotations. The business side, including billing and reimbursement, should also be incorporated as part of the MTM learning experience.3

CLINICAL ROTATIONS
One well-known platform, OutcomesMTM, emphasizes that pharmacy students play an important role in the delivery of MTM services by working with the pharmacy team to help provide personalized patient care.4 The literature demonstrates that pharmacy students can contribute to the delivery of MTM clinical care and services.5 The University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences in Aurora developed a 3-week MTM Advanced Pharmacy Practice Experience in collaboration with external community pharmacy partners.5 Thirty-five students performed MTM services via phone and provided face-to-face visits at pharmacies in the area under the supervision of a specialized MTM pharma- cist. Comprehensive medication reviews and targeted interventions focused on cost-effective alternative medications, medication adherence, pharmacotherapy recommendations, and reducing high-risk drugs for older adults (Figure). The study results showed that students helped to enhance workflow by completing comprehensive medication reviews, targeted interventions, and generated revenue for the pharmacies.5 This study demonstrates the importance of pharmacy students as part of the MTM team.



Another study evaluated the use of an online program as a virtual learning platform for training pharmacists and pharmacy students in providing MTM services for patients with diabetes.6 The program simulated 5 MTM meetings between a pharmacist or pharmacy student and the virtual patient. The study results showed that after completing the program, pharmacists and pharmacy students had increased knowledge and control over performing MTM services.6 This finding shows that practicing MTM services may increase the likelihood of students being successful at using these skills on pharmacy rotations.

In an interview, Ahzam Afzal, PharmD, founder/ managing partner of Frontizo in Bingham Farms, Michigan, discussed how his chronic care management company incorporates pharmacy students into MTM services with a focus on the COVID-19 pandemic.

Frontizo identifies patients who are at a higher risk of becoming severely ill with COVID-19 and conducts a targeted outreach to these individuals to ensure proper awareness and education are provided, he said.

Step-by-step education is offered, including a description of COVID-19, the importance of social distancing, prevention strategies, symptom identification, and words of encouragement. Patients are advised that if they are experiencing a cough, fever, or shortness of breath that they will receive a telemedicine consult with a physician. Those experiencing severe shortness of breath are instructed to call 911 immediately.

“We are leveraging our remote patient monitoring programs to monitor pulse oximetry very closely with our high-risk patient base,” Afzal said.

With a shortage of ventilators, patients who arrive at emergencydepartments with symptoms but who can walk on their own are being turned away and told to quarantine at home.

“Emergency room physicians would feel much more comfortable sending patients home with a remote pulse oximeter in which their pulse ox can be tracked,” Afzal said.

Frontizo’s program allows real-time monitoring, and this feature allows them to identify an issue quickly and triage patients with COVID-19 almost instantaneously.

Afzal emphasized that pharmacy students play an important role in patient education and also provide condition-specific assess- ments through telehealth services.

“Pharmacy students are working to ensure that all patients have enough supplies of their maintenance medications as the shelter- in-place orders have encompassed many states across the country,” Afzal said.


REFERENCES 
  1. Accreditation standards and key elements for the professional program in pharmacy leading to the doctor of pharmacy degree. Accreditation Council for Pharmacy Education. Published February 2, 2015. Accessed April 7, 2020. acpe-accredit.org/pdf/Standards2016FINAL.pdf 
  2. Poole TM, Kodali L, Pace AC. Integrating medication therapy management education into a core pharmacy curriculum. Am J Pharm Educ. 2016;80(4):70. doi: 10.5688/ajpe80470   
  3. Integrating medication therapy management (MTM) into the curricula of schools and colleges of pharmacy. American Pharmacists Association. Published March 2020. Accessed April 7, 2020.  pharmacist.com/sites/default/files/files/mtm_integrating_curricula_032012.pdf 
  4. Pharmacy technicians & students. OutcomesMTM. Accessed April 8, 2020.  outcomesmtm.com/pharmacy-technicians-students-2/  
  5. Vande Griend JP, Rodgers M, Nuffer W. Effect of an advanced pharmacy practice experience on medication therapy management services in a centralized retail pharmacy program. J Manag Care Spec Pharm. 2017;23(5):561-565. doi: 10.18553/jmcp.2017.23.5.561   
  6. Battaglia JN, Kieser MA, Bruskiewitz RH, Pitterle ME, Thorpe JM. An online virtual-patient program to teach pharmacists and pharmacy students how to provide diabetes-specific medication therapy management. Am J Pharm Educ. 2012;76(7):131. doi: 10.5688/ajpe767131