US Pharm. 2011;36(10):3.
It seems that every few years the profession of pharmacy tries to come up with some hot new buzzwords in attempting to explain what pharmacists do on a daily basis. Several years ago, pharmacists took on the title of “managed care specialists.” Unfortunately, somewhere along the way that catchphrase took on a decidedly negative connotation when third-party pharmacy organizations like pharmacy benefit managers and mail-order prescription providers decided they were, in fact, managed care specialists. The term was further watered down to simply “managed care,” which of course over time became a synonym for third-party payers of health care.
Eventually, pharmacists migrated from using the term “managed care” to describe their services and settled on “pharmaceutical care.” The belief was that this phrase better described the pharmaceutical aspect of managing patient care. In some professional circles, however, it was still considered a bit too broad a definition. I think the latest incarnation perfectly describes the services that pharmacists perform: “medication therapy management” (MTM). And the most important component of MTM is making sure a patient is compliant in taking the right medications exactly as prescribed.
According to the World Health Organization, approximately 125,000 patients die annually because of noncompliance with their medication therapies. In fact, noncompliance kills more Americans each year than accidents, influenza, and pneumonia combined and costs society over $175 billion. The New England Health Care Institute estimates that poor adherence to drug therapy imposes as much as $290 billion in annual health care costs, or 14% of all health care expenditures.
In reality, pharmacists have been performing MTM in their daily professional lives forever. But in the last couple of decades many have approached MTM in a more structured manner. New MTM programs have emerged all over the country. The granddaddy of these kinds of programs is known as the Ashville Project. Launched nearly 15 years ago in Ashville, North Carolina, it focused specifically on pharmacists managing drug therapies of city employees with diabetes. The results were inspiring. Job absenteeism due to poor medication control dropped an average of 50%, and the program saved approximately $400 to $600 a year in health care costs per patient, with nearly a 4-to-1 return on the city's investment. It was deemed a huge success and was replicated in many other states.
Pharmacists' involvement with MTM has also caught the attention of the medical community. A recent article published in the Archives of Internal Medicine acknowledged the role that pharmacists play in successfully managing cardiovascular disease risk factors such as hypertension and high cholesterol. According to the authors, while pharmacists have long been recognized for their important role as dispensers of medication, there has been a “transformation of pharmacy practice towards a more clinical, patient-centered role and a collaborative approach toward pharmacist-physician in patient care.” And a position paper from the American College of Physicians stated that it is “committed to fostering effective and productive collaborative relationships between pharmacists and physicians.”
That kind of recognition from the medical community is exhilarating. It is important that pharmacists engage in the practice of MTM as part of their ongoing professional development. Not only is it personally fulfilling, it is quickly becoming the new vision of pharmacy in the eyes of patients and other health care professionals alike. Pharmacists are on the cusp of finally being able to showcase their true professional value and worth to patients, other health care professionals, legislators, and third-party payers. The time to take action is now.
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