PQA Issues Call to Action to Improve Medication Therapy Management

The Pharmacy Quality Alliance (PQA) has released an 8-point call to action to improve the quality and measurement of medication therapy management (MTM) services. The authors noted that the call was established with extensive stakeholder input connected with a national, multi-phase initiative that PQA launched in 2023 to distinguish a pathway for new quality measures.¹

Image credit: Graphicroyalty | stock.adobe.com

“PQA, our members, and the health care community have been exploring opportunities to develop MTM quality measures focused on service quality and clinical end points for years,” Micah Cost, PharmD, MS, CAE, CEO of PQA, said in a news release. “Challenges persist related to data and practice variation, complicating the path to new measures. Our call to action outlines a series of interrelated and necessary areas where additional work is needed to advance MTM-related quality improvement and measurement.”¹

Published in Leadership for Medication Management, MTM is a variety of services that are provided to individual patients aimed to optimize therapeutic outcomes, along with detecting and preventing costly medication difficulties.² Medication-related issues are more prevalent among older individuals, as US adults 65 years and older consume more than 30% of all prescription medications, placing them at an increased risk for adverse drug events, according to the authors.³

The Centers for Medicare & Medicaid Services (CMS) requires Medicare Part D plan sponsors to launch an MTM program to guarantee covered Part D drugs are used correctly to optimize therapeutic outcomes and to reduce the risk of adverse events. This was developed following The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 which expanded patient access to MTM services and goals within Medicare Part D. This included educating and counseling to improve patient understanding of medications, improving adherence, and detecting adverse drug reactions and improper medication use. However, the authors noted that CMS requirements for Part D had expanded since its implementation in 2006.³

“CMS has made significant changes to the MTM program requirements over the years to enhance enrollment, improve the quality of services, and reduce gaps in care,” Lisa Hines, PharmD, CPHQ, chief quality and innovation officer at PQA, said in a news release. “In April, CMS finalized changes that will take effect next year and expand the eligibility criteria for the Part D MTM program. These significant changes to the MTM program and our call to action are an opportunity to advance the quality and measurement of MTM services.”¹

According to the news release, the call to action’s 8 elements include¹:

• Examine optimal MTM edibility and targeting criteria for achieving program goals.
• Improve collaboration between prescribers, MTM providers, and plan sponsors to address patient goals of care and apply appropriate medication changes.
• Elevate patient and prescriber awareness of Part D MTM services and the benefits patients may receive.
• Strengthen the patient voice to improve the patient-centeredness of MTM programs.
• Improve requirements for the use of standardized health information and technology for documentation of MTM services.
• Grow consistent use of the PQA Medication Therapy Problem Categories Framework through stakeholder education.
• Create new performance measures for MTM quality.
• Prioritize research to optimize the Part D MTM program and services.

The authors noted that the elements are not in priority order and require collaboration among stakeholders across the industry.¹

The changes can further MTMs intent in empowering and encouraging patients to have an active role in their health care. The authors noted that MTM services create a more unified partnership among patients, pharmacists, and physicians, as they work towards the same goal to provide optimum medication therapy.²

REFERENCES

1. PQA Call to Action Identifies Eight Areas for Improving Medication Therapy Management Service Quality and Measurement. PQA. News release,]. August 12, 2024. Accessed August 28, 2024. https://www.pqaalliance.org/pqa-call-to-action-identifies-eight-areas-for-improving-medication-therapy-management-service-quality-and-measurement.

2. Leadership for Medication Management. American College of Clinical Pharmacy. News release. May 16, 2007. Accessed August 27, 2024. chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.accp.com/docs/govt/advocacy/Leadership%20for%20Medication%20Management%20-%20MTM%20101.pdf.

3. Medication Therapy Management Interventions in Outpatient Settings [Internet]. National Library of Medicine. News release. November 2014. Accessed August 27, 2024. https://www.ncbi.nlm.nih.gov/books/NBK294478/.