A patient’s refusal to participate in medication therapy management sessions raises questions about how pharmacists are perceived by patients.
“I'll take drug advice from my MD, thanks,” was the title of a letter to the editor published in a recent issue of the Des Moines Register. The letter was a wake-up call for the Iowa Pharmacy Association (IPA), which urged its pharmacists to educate their patients about the benefits of medication therapy management (MTM).
As it turns out, patients may refuse services without fully understanding what MTM is or what they could gain from a thorough review of their medications. To complicate matters, they may think of pharmacists as extensions of their insurance companies—rather than independent, doctoral trained medication experts.
That was Phyllis Anderson’s first thought when a pharmacist asked whether she wanted to participate in an MTM session. Anderson described the encounter, which took place at the pharmacy’s drive-through window: “[The pharmacist] informed me that my insurance company had recommended me as a candidate to have my prescriptions reviewed. I responded, ‘Since when do I take insurance companies’ opinions over my physician’s?’”
To Anderson, a counseling session to “review her medications” suggested the pharmacist was colluding with her insurance company to “usurp the physician’s role,” as she put it. She refused the service.
The offer was extended on behalf of Outcomes Pharmaceutical Healthcare, a group that partners with plan sponsors and pharmacists to provide MTM sessions to eligible beneficiaries. According to IPA, more work is needed to help patients understand these benefits.
Both individual pharmacists and pharmacy associations must assume a larger role in promoting MTM to a broad audience of patients, the organization said. In a letter to the newspaper, IPA’s executive vice president and chief executive officer Thomas R. Temple, RPh, MS, defined MTM and addressed consumer concerns that the service undermines physicians’ prescribing power.
Emphasizing the collaborative aspects of MTM, Temple wrote, “Quality health care can be achieved best when physicians, pharmacists, and patients work together to achieve positive outcomes from medication therapy.” This message, though familiar to pharmacists, must reach patients if MTM is to become a routine pharmacy service.
Lack of patient understanding or cooperation may simply be evidence of a “transitional process,” according to IPA. To ease these growing pains, pharmacists should “begin or continue participating in Outcomes and other MTM programs to ensure patients receive the most appropriate and cost-effective therapy possible.”
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