Flexible Practice Models Can Expand Patient Care Services

During the COVID-19 pandemic, some medication therapy management (MTM) services shifted from face-to-face to virtual access and have become successful patient care models.

Additionally, virtual MTM consults have provided pharmacists with expanded career opportunities and the flexibility to work from anywhere in the United States. Community pharmacists’ ability to identify medication-related problems was comparable between face-to-face and telephonic MTM models, according to results of a retrospective analysis of comprehensive medication reviews (CMRs).^1,2 Advertising enhanced communication with patients and promoting innovative programs can help pave the way for successful MTM services (Figure^1-6).

One study evaluated an innovative MTM practice model that established an opioid misuse intervention program in a community pharmacy.³ First, a cross-sectional pharmacist survey was conducted with results showing limited pharmacist resources and/or training to address opioid misuse. The brief intervention MTM model, which identified and addressed patient opioid misuse, consisted of 9 sessions.³

One MTM consult was performed by a community pharmacist using motivational interviewing skills, and the remaining sessions were conducted via telephone for follow-up by a patient navigator who addressed goals and provided naloxone training.³ There were 333 patients screened, and pharmacists identified opioid misuse in 15% of the patients.³ This can serve as an important MTM innovative practice model for pharmacists, as drug overdose deaths dramatically increased during the COVID-19 pandemic.⁴

Telehealth can help MTM services promote long-distance patient care and public health, and it can be conducted through remote patient monitoring, store-and-forward imaging, telephonic communication, and video conferencing.¹ Innovative telepharmacy MTM services can include ambulatory care, chronic disease management, pharmacogenomics, and transitions of care.¹ This allows patients to participate in MTM services from their homes and removes barriers to health care such as immobility or travel issues.¹ Also, pharmacists can see patients’ OTC and prescription medications during MTM consults.

A variety of health literacy tools that can enhance communication with MTM patients to improve adherence and reduce the risk of adverse events (AEs).⁵ One of these tools can be accessed through the Agency for Healthcare Research and Quality. The Health Literacy Universal Precautions Toolkit uses the teach-back method to ensure that patients understand the information they have been provided.⁵ Evidence demonstrates that 40% to 80% of the medical information patients are told during office visits is forgotten immediately and approximately 50% is retained incorrectly.⁵ The teach-back method involves asking family members or patients to explain in their own words what they need to do or know.⁵ Pharmacists can check for patients’ understanding of the medication information and clarify any concerns.

Marketing an MTM practice is an important tool for a successful business model.⁶ It is critical that health care providers, patients, and payers are aware of the MTM services that pharmacists can provide. Pharmacists should first check with their supervisors about policies prior to advertising the MTM practice and obtain written confirmation.⁶

Next, they should determine the key features of the practice that would demonstrate improvement in patient health outcomes, such as decreased drug costs, fewer medication-related AEs, improved medication adherence, and reduced hospitalizations.⁶ Attending in-person or virtual pharmacy meetings is a great way to network and provide information about MTM services.⁶ Also, promoting services at community health fairs and informational nights, whether virtually or in person, at local senior centers can increase awareness of MTM services.⁶ Creating promotional brochures is another way to provide materials to the public, and advertising on social media platforms such as Facebook
and Twitter can also spread the word about MTM services.

Meeting with key decision makers at companies and small businesses can serve as the foundation of MTM’s marketing success.⁶

Jennifer Gershman, PharmD, CPh, PACS, is a drug information pharmacist and Pharmacy Times® contributor who resides in South Florida.

References

1. MTM models. The Medication Therapy Management Pharmacist Reference Book. Thomas DJ, Tran J, eds. The National Board of Medication Therapy Management.

2. Rivera J, Shcherbakova N, Vala C, Capoccia K. Community pharmacists’ interventions and documentation during medication therapy management encounters delivered face-to-face versus via telephone: the devil is in the details. Res Social Adm Pharm. 2020;16(10):1447-1451. doi:10.1016/j.sapharm.2019.12.020

3. Kenney A, Cox N, Bryan MA, Cochran G. Brief intervention medication therapy management: establishment of an opioid misuse intervention model delivered in a community pharmacy. Am J Health Syst Pharm. 2021;78(4):310-319. doi:10.1093/ajhp/zxaa389

4. Provisional drug overdose death counts. CDC. Updated January 12, 2022. Accessed January 14, 2022. https://www.cdc.gov/nchs/nvss/vsrr/ drug-overdose-data.htm

5. Health literacy tools for providers of medication therapy management. Agency for Healthcare Research and Quality. Updated September 2020. Accessed January 14, 2022. https://www.ahrq.gov/health-literacy/improve/ pharmacy/medication-mgt.html

6. Independent MTM pharmacist medication therapy management services: developing a practice as an independent MTM pharmacist. American Pharmacists Association. 2008. Accessed January 15, 2022. https://aphanet. pharmacist.com/sites/default/files/files/ mtm_developing_a_indie_practice.pdfa