Medication therapy management (MTM) represents the first major, pharmacy-wide, reimbursable cognitive pharmacy service. In the years since MTM was implemented, it has gained momentum as a comprehensive method to address the safety, appropriateness, and effectiveness of medications. Provision of MTM services allows pharmacists to identify omissions in therapy as well as address issues with polypharmacy. MTM follows the steps of the Pharmacists’ Patient Care Process: collect patient-specific information, assess the information to identify medication-related problems, create a patient-centered care plan, implement the care plan, and follow up with monitoring and evaluation. While MTM began as a Medicare-funded service, Medicaid and private health plans have also adopted the concepts of MTM. The services within the MTM scope are now integrated into mainstream healthcare in a variety of settings, including community pharmacies, hospitals, health plans, ambulatory care clinics, and university clinical practices. This text is our effort to provide information and an approach to MTM services that prepares the pharmacist to practice MTM in any setting.
As reimbursement models have transformed, pharmacists are now delivering MTM services in an efficient and effective way, providing patient care in a financial model that allows sustainability. MTM services can play an even larger role as the healthcare system evolves toward a pay-for-performance model that requires more value-based care. In some cases, MTM services have shown improved patient care and decreased healthcare costs. The next challenge is to continue to prove the cost savings and value that MTM practitioners bring to patients and the healthcare system.
The second edition has been updated to reflect current practice, yet it is a snapshot of MTM and therapeutics at one moment in time. We realize that the medication-use system is changing at a faster pace than therapeutics. However, the principles found in this text are applicable regardless of the practice setting or the introduction of new drugs, guidelines, or payment methods.
Our hope is that this text will be a useful resource that promotes the development of successful MTM services and more widespread adoption of MTM. As the medication-use system and therapeutics evolve, we will continue to update and refine the text to best meet the needs of MTM providers and the patients they serve.