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KEY POINTS

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  • The comprehensive medication review (CMR) is an essential element of MTM. The CMR involves an interactive face-to-face or telehealth medication review and is a systematic process of collecting patient-specific data, assessing medication therapies to identify medication-related problems, prioritizing a list of medication-related problems, and creating a plan to resolve them with the patient, caregiver, and prescriber.

  • Good clinical decisions require good data; before making recommendations to prescribers the MTM provider should attempt to collect the most accurate drug use information using all available resources.

  • Discrepancies and inaccuracies can occur in any setting in which the medication review takes place; it is helpful to understand what discrepancies can occur during the CMR and be prepared to take action to collect the most accurate medication list.

  • Preparation of both the patient and the MTM pharmacist is necessary.

  • Before performing the CMR, the MTM pharmacist should gather a drug list, determine and confirm disease states, identify healthcare providers, and identify potential medication-related problems.

  • Efficiency is important when conducting the CMR as the MTM pharmacist must address the objectives of all parties involved, as well as collect all required data necessary to make accurate and helpful recommendations with the patient's healthcare team.

  • Documenting a care plan creates a record of the patient interaction and rationalization for the MTM decision-making process. It also allows for continuity of care and is usually required for reimbursement.

  • The patient medication list (PML) is patient-directed and should contain any prescription medications, OTC medications, and medical supplies.

  • The medication action plan (MAP) is the patient's guide to medications as well as disease states and should include empowering actions to assist him or her in reaching the agreed-upon health goals.

  • When communicating with a physician it is important to be informative and suggestive, as well as concise and respectful.

  • Follow-up allows the MTM pharmacist to monitor the resolution of issues and identify any new medication-related problems.

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INTRODUCTION TO MEDICATION THERAPY MANAGEMENT AND THE COMPREHENSIVE MEDICATION REVIEW

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Definitions

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The American Pharmacists Association, the National Association of Chain Drug Stores, and the Centers for Medicare and Medicaid Services (CMS) have defined 5 core elements of medication therapy management (MTM):

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  1. A CMR.

  2. A PML, which is a record of all of the patient's medications (including prescriptions, over-the-counter medications, herbals, and dietary supplements).

  3. A MAP, which is a patient-centered document which empowers the patient to take personal action and track their progress of self-management.

  4. Intervention and referral to other healthcare professionals as appropriate.

  5. Documentation and follow-up.1, and 2

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An essential element of MTM is the CMR, described by CMS as a systematic process of collecting patient-specific information, assessing medication therapies to identify medication-related problems, developing a prioritized list of medication-related problems, and creating a plan to resolve them with the patient, caregiver, and prescriber. The CMR involves an interactive person-to-person or telehealth medication review and consultation conducted ...

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