Building a CDTM Program Means Starting Small

At the New England Institute of Ambulatory Care Pharmacists (NEIAP) 2026 Annual Forum in Boston, Massachusetts, Jackie Burke, PharmD, clinical pharmacy manager at Atrius Health, discussed the biggest gaps and barriers in collaborative drug therapy management (CDTM) practice.

Speaking ahead of her panel at the Annual Forum, titled “Turning Knowledge Into Action,” Burke said the widest gap between what the evidence supports and what pharmacists can actually implement is not the pharmacist's clinical expertise—stakeholders already believe in the care pharmacists provide. Instead, the gap is operational: designing workflows that make sense for everyone involved, implementing them, and then capturing outcomes in a form digestible to the right audience. Doing so, she said, lets organizations use that information to make further decisions and, ideally, expand the pharmacist's role both within an organization and at others.

Discussing barriers, Burke emphasized that obstacles shift over time and that adaptability and program flexibility are essential to meeting stakeholder needs. She pointed to a specific regulatory constraint in Massachusetts, where only physicians can refer patients to CDTM pharmacists. Because nurse practitioners in the state can now practice independently and maintain their own patient panels, she said, the referral rules leave pharmacists constrained in how they can serve those patients—a barrier outside the organization's control.

Institutionally, she noted that while providers generally recognize the need for clinical pharmacists, a common challenge is that they may want pharmacists to do everything. Managing that means keeping work within a scope that fits both the local office and the broader organization and that remains a sustainable model. Her recommended approach is to start small and grow from there.