Proving the Benefits of MTM Will Take Time

The Agency for Healthcare Research and Quality (AHRQ) has released a draft systematic review of medication therapy management (MTM) finding that there is insufficient evidence to support the positive benefit of MTM on most outcomes. Should pharmacists be discouraged by these findings? I don’t think so.

The fact that AHRQ even commissioned this study suggests that pharmacists have the agency’s attention and provides evidence of the growing recognition that pharmacists are making a valuable contribution to health care beyond their traditional dispensing function. Early on, any new health care service or program can provide little evidence of its value beyond anecdotes. Such is the case with MTM.

Nonetheless, many pharmacists can tell stories of patients who have benefitted from MTM and of patients’ family members who have thanked them for helping their loved ones manage their medication.

The AHRQ report preface states: “Systematic reviews are the building blocks underlying evidence-based practice; they focus attention on the strength and limits of evidence from research studies about the effectiveness and safety of a clinical intervention. In the context of developing recommendations for practice, systematic reviews can help clarify whether assertions about the value of the intervention are based on strong evidence from clinical studies.”

The report concludes: “For a limited number of outcomes, we found evidence that MTM results in improvement when compared with usual care (low strength). Specifically, these outcomes include medication appropriateness, the rate of hospitalization among heart failure patients with home medicines review, and the use of generic medications for patients receiving MTM from community pharmacy when compared with educational mailings.”

I conclude that we pharmacists are making progress in showing our value. Almost every study I read notes that further study is required to validate the results. I think we can say the same in this case. Further studies and perhaps better or larger studies are needed to determine the benefits of MTM. While further studies are carried out, pharmacists will continue to take care of patients—and they and society as a whole will be the ultimate beneficiaries.