Techs Can Take Charge of MTM in 3 Key Ways

Medication therapy management (MTM) has been defined as “a distinct service or group of services that optimize therapeutic outcomes for individual patients.”¹

Several clinical staff members, including pharmacy technicians, have active roles in patient care. One of the most important tasks of the clinical tech is to monitor medication adherence. Techs also serve as shared points of contact for communication among patients and members of the treatment team. Moreover, the tech contributes to MTM by performing medication reconciliations, monitoring within outpatient clinics, and working directly with patients.

MEDICATION RECONCILIATION

Medication reconciliation is the process of gathering an accurate medication history in each level of patient care. Techs obtain the medical history upon patients’ admission, discharge, respite care, and transfers to other units. They can contact other health care facilities, pharmacies, and providers for medical records. Techs are also qualified to meet with patients, assess their medication adherence, and document any discrepancies for the pharmacist to review. In addition, they can forward any medical concerns or medication questions to the supervising pharmacist.

What’s more, like pharmacists, techs are familiar with the extra measures required for antibiotics, high-risk medications, intravenous therapy, and nonformulary medications.

The study results in the article “Best Possible Medication History in the Emergency Department: Comparing Pharmacy Technicians and Pharmacists” showed that techs were able to obtain a medication history with “as much accuracy and completeness as pharmacists. Both groups were significantly superior to the national average in terms of unintentional discrepancies and success index for medication reconciliation.”¹

The results further indicated, “Fifty-nine patients were included in the study, and 3 pharmacists and 2 technicians obtained the histories. There was no significant difference between pharmacists and technicians in terms of discrepancies involving prescription drugs or over-the-counter medications.”²

ACCOUNTABILITY AND EFFICACY

In some health care facilities, the anticoagulation and hepatitis C virus clinics are closely monitored with the assistance of a tech. The anticoagulant clinic requires the tech to follow up with patients regarding their direct-acting oral anticoagulants. The tech frees up the pharmacist by taking on this task of scheduled follow-up calls, which are an effective means of communication that focuses on patient-centered care.

Several unscreened and untreated patients require infectious disease consults for treatment of their hepatitis C virus. In this instance, the responsibilities of the tech include monitoring hepatitis C medication refills, placing follow-up calls for the first week of therapy, and reminding patients about 12-week sustained virologic response labs. The tech also works with other members of the team to identify, treat, and cure patients.

PATIENT-CENTERED CARE

The patient—provider relationship is a vital part of quality health care. The tech’s assistance helps pharmacists eliminate inconsistencies and improve patient engagement.

Certified pharmacy technicians (CPhTs) have assumed the role of community health workers to enhance patient movement within the health care system as part of the SafeMed program. One article concluded that “the early experience of the SafeMed program demonstrates that CPhT-[community health workers (CHWs)] are well suited for novel expanded roles to improve care transitions for superutilizing populations. CPhT-CHWs can identify and report potential [drug therapy problems] to the pharmacist to help target medication therapy management. Critical success factors include strong CPhT-CHW patient-centered communication skills and strong pharmacist champions. In collaboration with state pharmacy boards and pharmacist associations, the SafeMed CPhT-CHW model can be successfully scaled to serve superutilizing patients throughout the country.”³

CONCLUSION

Now is the time to use techs for MTM. Education institutions offer MTM training, and courses are available through the American Society of Health-Systems Pharmacists and the Pharmacy Technician Certification Board. Techs are already proficient in pharmacy services, allowing them to easily adapt to any situation. The tech plays a key role in communication, medication reconciliation, and patient care—helping to avoid medication errors that lead to adverse events and providing accurate documentation to ultimately save lives.

Angela Berthau, CPhT, is a clinical pharmacy technician at the Department of Veterans Affairs in Coatesville, Pennsylvania.

REFERENCES

• Bluml BM. Definition of medication therapy management: development of profes- sionwide consensus. J Am Pharm Assoc (2003). 2005;45(5):566-572.
• Johnston R, Saulnier L, Gould O. Best possible medication history in the emergen- cy department: comparing pharmacy technicians and pharmacists. Can J Hosp Pharm. 2010;63(5):359-365. doi: 10.4212/cjhp.v63i5.947.
• Bailey JE, Surbhi S, Bell PC, Jones AM, Rashed S, Ugwueke MO. SafeMed: using pharmacy technicians in a novel role as community health workers to improve transitions of care. J Am Pharm Assoc (2003). 2016;56(1):73-81. doi: 10.1016/j. japh.2015.11.011.