Skip to Main Content

++

After reading this chapter, the pharmacy student, community practice resident, or pharmacist should be able to:

++

  1. Explain how pharmacists are in a unique position to provide medication therapy management (MTM) services.

  2. Recognize the differences between MTM and pharmaceutical care.

  3. Explain how MTM services are implemented with the five core elements.

  4. Discuss how innovative patient care programs have assisted in the development of MTM.

  5. Recognize how implementation of MTM services is evolving into the overall health-care structure.

++

Nearly half of all Americans have at least one chronic illness1 resulting in millions of patients relying on prescription medications to help maintain their health. This prevalence of medication use creates a significant opportunity for both medical and monetary consequences if these agents are not managed safely and effectively. Unfortunately, evidence suggests that our health system is not performing well in this regard. It is estimated that 1.5 million preventable adverse drug events (ADEs) occur in our health system each year2 and the Institute of Medicine (IOM) has declared that for every dollar spent on ambulatory medications, another dollar is spent to treat new health problems caused by the medication.3 Despite the presence of these avoidable adverse events and costs, it has been determined that potentially up to half of patients on persistent medication receive no drug monitoring in 1 year.45 The IOM predicts that with these trends, the number and costs of outpatient ADEs will increase unless effective interventions to improve health-care system delivery and outpatient safety are implemented.

++

There are multiple factors that contribute to the medication use problems and their negative outcomes. These include patient-centered factors, therapy-related factors, social and economic factors, and disease factors.6Health literacy, cost, concern about adverse effects, lack of urgency about the disease, and an impaired perception of the efficacy of the medications are just a few specific patient-centered examples. Societal issues like poverty, cultural differences, and a lack of a social support structure create obstacles for treating the population as a whole. Lastly, problems with the health-care system such as lack of accessibility, long waiting times, difficulties filling prescriptions, or unpleasant interactions with health-care professionals also affect patient's medication use experience and may result in medication-related problems.

++

Pharmacists are in an excellent position to address these problems due to their focused training, unique perspective, and unparalleled access. Pharmacists have the most specific training in drug therapy of all health-care professionals, which creates an opportunity to evaluate a patient's medication needs in a manner that is unique to the health-care team. In the ambulatory care environment, pharmacists are the most accessible health-care professionals. While most health-care professionals require an appointment or emergency situation to be accessible to patients, the ease of access to community pharmacists allows them to often serve as the first and/or the most frequent point of contact between a patient and their health-care team.

++

However, to take ...

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.

Ok

About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

AccessPharmacy Full Site: One-Year Subscription

Connect to the full suite of AccessPharmacy content and resources including 30+ textbooks such as Pharmacotherapy: A Pathophysiologic Approach and Goodman & Gilman's The Pharmacological Basis of Therapeutics, high-quality videos, images, and animations, interactive board review, drug and herb/supplements databases, and more.

$595 USD
Buy Now

Pay Per View: Timed Access to all of AccessPharmacy

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.