Tip of the Week: An Implementation Framework Is Key to Launching MTM Service


Evidence suggests that there are many barriers to the proper implementation of MTM services, including time constraints and lack of staff support.

Medication therapy management (MTM) has become increasingly commonplace in the lexicon of pharmacy practice. MTM, in general, revolves around enhancing and optimizing patients’ medications and thereby identifying and averting medication errors. Evidence suggests that there are many barriers to the proper implementation of MTM services, including time constraints and lack of staff support. Inconsistent implementation of MTM services may be due at least in part to ambiguity surrounding the concept of MTM and lack of support in implementing the service.

Hohmeier et al. developed an adaptation framework of MTM for pharmacies and observed the effects of educational interventions on the implementation of MTM services.1 This study measured the percentage of completed comprehensive medication reviews (CMRs) and targeted medication reviews (TMRs), in addition to pharmacists’ perceptions of MTM beliefs, knowledge, and implementation self-efficacy pre- and post-intervention.

They observed that educational interventions aimed at adaptation of MTM services in community pharmacy helped bolster MTM completion rates by 11.4%. They also noted that providing educational materials through an MTM adaptability framework would positively change perceptions of MTM feasibility and self-efficacy. The adaptability framework was designed to simplify and connect concepts related to MTM by comparing the scopes of various direct patient care services provided by pharmacists, aligning pharmacist-provided direct patient care, and providing a structure to systematically approach the delivery of each type of MTM service.1

The study demonstrated the importance of an effective implementation strategy. By providing an adaptation framework for a new service and supporting the pharmacists and staff during the implementation phase, both the completion rate and the staff perceptions of the service can be positively impacted. Although most of the strategic planning for implementing a new service may not come from the individuals actually carrying out the service, particularly in large organizations, knowing the importance of an effective implementation framework should act as an incentive to provide a foundation for the personnel actually responsible for carrying out the service.

At the store level, having support and educating staff on the implementation of a new service would not only increase the completion rate for that initiative but could also positively impact the perception of the staff toward the new service. Pharmacy leaders and staff should take every opportunity to become more knowledgeable in the field of implementation science, which concerns the success and long-term sustainability of patient services.

Additional information about Implementing Value-Added Pharmacist Services can be found in Pharmacy Management: Essentials for All Practice Settings, 5e.

Sina Hosseini is a PharmD Candidate at Touro University in California.

Shane P. Desselle, PhD, is a professor of social and behavioral pharmacy at Touro University California.


1. Hohmeier KC, Wheeler JS, Turner K, et al. Targeting adaptability to improve Medication Therapy Management (MTM) implementation in community pharmacy. Implement Sci. 2019;14(1):99. Published 2019 Nov 27.