Core Elements of Medication Therapy Management (MTM) Services’ Model Framework

1. Core Elements of Medication Therapy Management (MTM) Services’ Model Framework Anne Burns, RPh Group Director, Practice Development and Research American Pharmacists Association

2. Medication Therapy Management Services: A Consensus Definition • Three inseparable elements: • Primary Definition: services that optimize therapeutic outcomes… • Professional Service Components: MTM encompasses a broad range of activities and responsibilities within a pharmacist’s scope of practice… • Program Elements: MTM Programs shall include (core criteria for an MTM program)…

3. The Challenge of Defining MTMS • Create a definition that is: • Applicable to diverse pharmacy practice segments • Feasible for a majority of practices to individually implement • Supported by professional organizations to bolster efforts in lobbying for regulatory language

4. MTMS Endorsing Organizations • Academy of Managed Care Pharmacy • American Association of Colleges of Pharmacy • American College of Apothecaries • American College of Clinical Pharmacy • American Pharmacists Association • American Society of Consultant Pharmacists • American Society of Health-System Pharmacists • National Association of Boards of Pharmacy* • National Association of Chain Drug Stores • National Community Pharmacists Association • National Council of State Association Executives *Organization policy does not allow NABP to take a position on payment issues.

5. MTM Model Core Elements in Community Pharmacy • Uses the MTM Definition as the basis for developing core elements of an MTM service in community pharmacy • Created by APhA and NACDS with the input of an advisory panel of community pharmacy practice leaders involved in MTM delivery • February 8, 2005: MTM Advisory Panel meeting • April 27, 2005: core elements finalized

6. Advisory Panel: Key MTM Model Concepts • Applicable to all patients in need of MTM services • Patient-centered – empower patient to self-manage medications • Importance of collaboration with physicians and other health care providers • Facilitate continuity of care • Able to be delivered by large numbers of pharmacists • Distinct from dispensing

7. Advisory Panel: What Aids in Successful MTM Delivery? • Pharmacists have dedicated time to provide MTM services • Significant outreach to educate patients and physicians about the value of MTM services • Risk stratification models to determine patients who could benefit most from MTM services • A consistent, efficient format for documentation of MTM services • Outcomes measures to measure the impact of MTM services

8. MTM Model Core Elements • Medication Therapy Review (MTR) • Personal Medication Record (PMR) • Medication Action Plan (MAP) • Intervention and/or referral • Documentation and follow-up

9. MTM Model Core Elements: Medication Therapy Review • Model core elements document advocates for: • Annual Comprehensive Medication Therapy Review (MTR) designed to improve patients’ self-management of medications • Targeted Medication Therapy Reviews (MTRs) to address new medication problems or for medication therapy monitoring follow-up

10. MTM Model Core Elements • Personal Medication Record (PMR) – patient receives a PMR at the end of a comprehensive MTR • Medication Action Plan (MAP) – patient-focused document containing information the patient can use to improve medication self-management

11. MTM Model Core Elements • Intervention/referral – pharmacist intervenes to address medication-related problems or refers the patient to the appropriate health care provider • Documentation/follow-up – pharmacist documents services in a manner appropriate for evaluating patient progress and billing and schedules a follow-up visit

12. Questions? Anne Burns 202-429-7522 aburns@aphanet.org