Medication management services are the experienced, measurable events when pharmaceutical care is practiced.
Two distinct approaches to medication management services have emerged: the prescription-focused and the patient-centered approaches. This book is about the patient-centered approach.
The need for medication management services results from more complex therapies, increase in the number of medications prescribed and the cost of new medications, as well as the lack of a structured, systematic decision making process for drug selection and dosing.
Solutions to address the high level of drug-related morbidity and mortality have been in place at the policy and institutional levels with some success. However, it is the intervention at the patient-specific level that impacts decisions made on a daily basis for an individual patient. Medication management services “fit” at the patient-specific level of improving medication use.
Medication management services should be available to all patients who need them. Access should not be limited until we understand more about who will benefit most from the service.
The value of medication management services has been established, documented, published, and reproduced in many practice settings around the world.
Medication management services are being delivered in the ambulatory and institutional settings. They are recognized in the medical home and accountable care environments, and can function anywhere patients and qualified practitioners come together.
Medication management services are relatively new to those in and out of the health care professions. The first use of the term on a broad scale in the United States was in 2006 when the Federal Government implemented a new drug benefit (Part D) within the federal insurance program of Medicare, which now includes a drug benefit for the elderly population. As part of this benefit a new service was required to help patients to manage these “covered” medications and this new service was called medication therapy management. This phrase was taken from terminology used in the British Health System where it referred to managing treatment options and was called therapy management. When the term was imported to the United States and applied to the management of medications taken by the beneficiaries of the Medicare program, it became medication therapy management.
A clear definition of the term medication therapy management did not accompany the introduction of the benefit to the elderly. This may explain why so many different definitions of the concept have arisen, each with a slightly different emphasis, depending on the organization defining the term. Generally speaking, however, there are two different approaches being taken to medication therapy management: the prescription-focused approach and the patient-centered approach. Each of these will be described in detail later in this chapter; however, first we will define patient-centered medication management because it will be the focus of this book. We should also clarify at this point that we will be using the term medication therapy management to refer only to the program defined by the Federal Government in Part D of the Medicare Program, and we will be ...