Name of the Procedure:

Medication Therapy Management Service(s) (MTM), provided by a pharmacist, individual face-to-face with patient, with assessment and intervention if provided; each additional 15 minutes.

Summary

Medication Therapy Management (MTM) is a service provided by pharmacists where they meet face-to-face with patients to review their medications, discuss their health conditions, and make any necessary adjustments to optimize therapy. This may include assessing the patient's medication regimen and making recommendations for changes or interventions.

Purpose

MTM aims to ensure patients are taking their medications correctly and safely to manage their health conditions effectively. The goals include improving medication adherence, reducing the risk of adverse drug interactions, and ensuring overall better health outcomes.

Indications

MTM is indicated for patients who:

• Take multiple medications.
• Have chronic health conditions such as diabetes, hypertension, or asthma.
• Have experienced recent changes in their medication regimen.
• Are at risk for medication errors or adverse drug reactions.

Preparation

Patients should:

• Bring a list of all their medications, including prescriptions, over-the-counter drugs, and supplements.
• Be prepared to discuss their medical history, current health conditions, and any concerns about their medications.
• No specific fasting or diagnostic tests are generally required.

Procedure Description

1. The pharmacist reviews the patient’s medication list and medical history.
2. The pharmacist assesses the medication regimen, checking for drug interactions, duplications, and adherence issues.
3. The pharmacist discusses findings with the patient and educates them on proper medication use.
4. Recommendations for adjustments or interventions are made as needed.
5. A follow-up plan is established.

Tools used include medication records, patient medical history, and possibly electronic health records. This is typically a conversational and educational session with no need for anesthesia or sedation.

Duration

The additional MTM service typically takes 15 minutes per session beyond the initial assessment.

Setting

MTM services are usually performed in outpatient settings such as community pharmacies or clinics.

Personnel

The primary healthcare professional involved is a licensed pharmacist.

Risks and Complications

MTM is a non-invasive procedure with minimal risks. However, potential risks include:

• Misinterpretation of medication information by the patient.
• Incorrect changes to medication if communication issues arise.

Management of these risks involves clear, direct communication and thorough documentation.

Benefits

• Improved medication adherence and understanding.
• Reduced risk of adverse drug interactions and side effects.
• Better management of chronic conditions and overall health improvements.
• Benefits are often realized shortly after the session, particularly in patient understanding and adherence.

Recovery

MTM requires no physical recovery. Patients will immediately apply the education and recommendations provided by the pharmacist. Follow-up appointments might be scheduled to monitor progress.

Alternatives

• Comprehensive medication review by a primary care physician.
• Automated medication management systems.
• Comparison: MTM by a pharmacist provides a more personalized, face-to-face counseling session.

Patient Experience

Patients can expect a detailed discussion about their medications and health concerns. The session is usually comfortable, informal, and focused on education. Proper pain management or comfort measures are typically unnecessary due to the non-invasive nature of MTM.