Pharmacists Prepared to Implement MTM

Every single day, patients are admitted to the hospital with a laundry list of medications taken at home. The primary care physician is nowhere to be found in the hospital, and the hospital physician has to take on the job of looking at the patient's home medications and deciding what to do.

What usually happens is the hospital prescriber or specialist checks to continue all home medications without a second thought. Why? It's the idea that the patient has presented for an acute process that needs to be managed, and assessing a medication taken for UTI suppression at home isn't their job. Or is it?

This “continue without a second look” approach causes errors that can affect days admitted to the hospital, medication interactions between home and hospital medications, and duplication in therapy. Pharmacists in hospitals attempt to intervene, but with the current setups of distribution pharmacy versus clinical pharmacy, this caveat can slip through the cracks without proper billing/payment, so that hospitals can justify another full-time equivalent solely for this purpose.

According to the American Pharmacists Association, medication therapy management (MTM) describes a broad range of health care services provided by pharmacists, the medication experts on the health care team. As defined in a consensus definition adopted by the pharmacy profession in 2004, MTM is a service or group of services that optimize therapeutic outcomes for individual patients.

MTM services include medication therapy reviews, pharmacotherapy consults, anticoagulation management, immunizations, health and wellness programs, and many other clinical tasks. Pharmacists provide MTM to help patients reap the best benefits from their medications by actively managing drug therapy and identifying, preventing, and resolving medication-related problems.

Part of the difficulty in implementing MTM is proving to a hospital corporation that a pharmacist could save health care dollars by preventing hospital readmissions. In the ambulatory care setting, a pharmacist is not able to bill for these services unless collaboratively, hence the importance of the pharmacy provider status bill passing in the US House and Senate.

The Indian Health Service and the Veterans Administration have been using highly trained pharmacists for 40 years to manage chronic conditions. In addition, the US Centers for Medicare and Medicaid Services already has verbiage addressing this need.

It has been estimated that 1.5 million preventable adverse events occur each year, resulting in billions of dollars in damages and even death. Although patients aren't typically admitted to the hospital for home medication issues, pharmacists are the right health care team members to address patients from a medication standpoint.

MTM is a unique niche for the pharmacy profession, allowing pharmacists to apply their extensive knowledge as medication experts with the goal of improving patient outcomes and thus saving money in the ambulatory setting and even the hospital setting.

Pharmacists are ready to take on the job that others have overlooked.