Medication Therapy Management (MTM) Plays a Critical Role in Improving Patient Outcomes and Reducing Healthcare Costs
- Patients with multiple providers and use multiple pharmacies (universal EMR would really help here, especially ones where patients could enter their OTC and herbal supplements they are taking).
- Patients who require additional education about their medications (most of us)
- Patients on multiple long term medications, or who have a chronic condition (asthma, CHF, diabetes, high blood pressure, elevated cholesterol, etc.)
- Patients who require close monitoring (on anticoagulants, insulin)
- Patients (and caregivers) in care transitions, especially after hospital discharge in their home or care facility environment. (Do they have their new meds, know how to take them, are they compatible with other medications and know dietary restrictions/interactions?)
- Patients with a new prescription or a dosage change to their current treatment regimen.
After recent conversations with several pharmacists who currently provides MTM services, average cost for an MTM consult varies between $40.00 and $75.00 (good bang for the buck, cheaper than my monthly hair appointment, and far more economical than an emergency room admission) and can take up to an hour. Follow-up appointments run about $35.00. Anyone can request an MTM appointment and patients can contact their insurer to determine if the service is a covered benefit. Some companies offer the service via telephone (another potential growth area for telehealth). There are advanced MTM certification programs for pharmacists, but according to pharmacists I spoke with, all pharmacists have the knowledge to provide this type of service, but depending on the institution they are practicing in , time constraints and work flow may not allow for an appointment based, thorough review (Walgreens provides it, I asked).
Significant findings on this topic are that patients rarely request an MTM visit on their own. This, I believe, is because there is a lack of awareness of the availability and benefits of such a service and a huge lack of awareness of the potential for drug interactions, particularly with over-the-counter medications and herbal supplements. How about physicians start prescribing MTM to their patients when adding or changing prescriptions?
Post hospital discharge and any physical care transitions are a good place to initiate MTM services and the Patient Centered Medical Home (PCMH) platform is where it should live and dwell (a no-brainer).
I welcome any contributions you can make on your program or plans for MTM services in your organization.
More on MTM:
http://www.amcp.org/data/jmcp/018-031.pdf
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Dr. Erik Fransen:
March 29th, 2012 at 10:26 am
Dear all,
the above mentioned appears to be a huge burden for pharmacists as well as patients. Yet, there is a much simpler solution available. The central point of Vitaphone PICO medication adherence support system are the medication pouches which are packed per intake moment. The production of these pouches is done in a highly secured place, so medication errors are limited to a minimum. On top of that, spill medication is almost non-existing. Most important, patients as well as pharmacists are very enthusiastic about the system.
So, I think it is time the USA also starts to catch up with this option!
Kind regards,
Dr. Erik Fransen
Manager Medical Programs
Vitaphone Telemedicine
Wayne Miller, MBA, RPh:
March 29th, 2012 at 3:39 pm
Tools such as the Vitaphone can play a role in improving adherence, however, MTM as comprehensive patient centered care encompasses a collaborative approach to managing medication therapy that requires review, assessment, and recommendations for reaching the medication therapy goals and clinical outcomes for each patient.