US Pharm. 2017;42(6):2.

Medication therapy management (MTM), a concept charged ultimately with improving healthcare outcomes, has undergone several facelifts over the past decade or so. First defined by the pharmacy profession in 2004, MTM further crystalized during a September 2006 Capitol Hill briefing against the backdrop of its role in Medicare Part D legislation.

Subsequently, as Mary Ann Zagaria, PharmD, MS, BCGP, writes in this issue’s Senior Care column, the American Pharmacists Association and the National Association of Chain Drug Stores Foundation developed a model framework known as the Medication Therapy Management in Community Pharmacy Practice: Core Elements of an MTM Service Version 1.0.  A second version, published in 2008, sought to “improve continuity of care and patient outcomes” by achieving a maximum level of “effectiveness and efficiency of MTM service” across a variety of pharmacy practice settings.

For an excellent overview of MTM’s progression during the past decade or so and the likely course ahead, read this month’s Senior Care column. Dr. Zagaria deftly chronicles the development of MTM, noting that “healthcare practitioners, pharmacy associations, policymakers, and other stakeholders and organizations that support pharmacist provider status understand that its impact will dovetail with the CMS’s [Centers for Medicare and Medicaid Services] desire to achieve better alignment of PDP [prescription-drug plan] sponsor and government financial interests.”

Additionally, Dr. Zagaria writes, with the unique and exceptional skill set of pharmacists, enhanced MTM will be better situated to create incentives for investment and development of innovative MTM interventions.

Indeed, patients coping with pervasive disease states—and the healthcare system itself—stand to benefit from MTM. In this issue’s cover article, “Managing Chronic Kidney Disease [CKD] With MTM,” authors Samuel M. John, PharmD, BCPS; Candis McGraw-Senat, PharmD, BCACP;  Drew W. Cates, PharmD, AAHIVP; and Melissa Williams and Hiral Gandhi, both PharmD candidates, contend pharmacists can positively impact the overall care of CKD patients with MTM clinical services targeted towards “safe and efficacious outcomes.” Bringing pharmacists into an interdisciplinary team approach in the care of the CKD patient, they write, can be both “cost-effective to the healthcare system and beneficial to patients.”

In this month’s continuing education article, “Applying MTM to the Geriatric Cardiovascular Patient,” author Donna M. Lisi, PharmD, BCPS, BCPP, writes that the Medicare Modernization Act, which resulted in the formation of Medicare Part D and the development of mandatory MTM programs for selected Medicare beneficiaries, has paved the way for pharmacists to exploit their clinical skills to benefit patients. With the current focus on a quality-based reimbursement structure as opposed to a fee-for-service model, Dr. Lisi writes, pharmacists can play a pivotal role in containing costs by participating in drug selection; preventing and monitoring for adverse drug reactions and drug interactions; and promoting adherence.

In “Implementing MTM for COPD,” Terri M. Wensel, PharmD, BCPS, TTS; Jeffrey A. Kyle, PharmD, BCPS; and Megan McCarter, PharmD, write that pharmacists are in a prime position to intervene through an MTM encounter to achieve better outcomes. Decreasing or preventing COPD exacerbations, they point out, decreases healthcare costs and the social burdens patients may face. Pharmacists can inform a physician that an inhaler is not providing relief, ensure that a patient is up-to-date on vaccinations, and assess a patient’s willingness to quit smoking.

There is no doubt that MTM is gaining steam, and it is up to pharmacists to maximize the full potential that it promises—for both the profession itself and the patients they serve. 

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