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Understanding Medication Therapy Management

Suppose you have a Medicare Part D prescription drug plan or HealthPartners Medicare Advantage (Part C) with prescription drug coverage. In that case, our specialized pharmacists can help you get the most from your medicines. This service is free to you if you qualify.

MTM is a comprehensive service model incorporating medication reconciliation and targeted medication reviews. This is a longitudinal intervention.

Medications

Medications are prescription drugs used to treat, cure or prevent disease. They may contain active or inactive ingredients and come in many different forms, including pills (tablets or capsules), liquids or suppositories. They are often short-, medium- or long-acting, affecting the body for different lengths.

Understanding the basics of what is medication therapy management can be effective for treating diseases but can also cause side effects. These side effects can range from mild to severe. They can even be life-threatening.

Medication therapy management, or MTM, is a service that pharmacists provide to help improve patient outcomes by managing their medications. It involves two processes: medication reconciliation and medication review. The MTM process aims to improve adherence, reduce drug-related problems and optimize therapeutic outcomes. Studies show that MTM can significantly enhance the number of times a patient takes their medicine as prescribed. It also can reduce costs and increase the efficiency of care. These improvements can be measured by comparing outcomes before and after MTM interventions. The strength of evidence for most of these outcomes is low.

Conditions

A medication therapy management (MTM) program is a group of pharmacist-provided services designed to optimize therapeutic outcomes for patients with various conditions. These services can be classified into three categories: disease management, case management and self-management interventions. These intervention types can be subdivided into specific MTM components, such as medication reviews and patient education.

MTM can be provided comprehensively or targeted, depending on the condition(s) being treated and the type of medications used. For example, an MTM intervention that focuses on a patient with diabetes may include a personal medication record or a medication review and may include counseling to help improve adherence to the treatment plan.

The MTM service is free to members who qualify, and a healthcare provider will review your prescription, over-the-counter and herbal/supplement medications over the phone with you. The purpose is to ensure your drugs are safe, effective and are helping you manage your health conditions. You can qualify for MTM by meeting our MTM criteria determined quarterly using medical and pharmacy claims information.

Comorbidities

Comorbidities are the presence of two or more conditions that coexist. They can be physical or mental health concerns. They are typically chronic (long-term) concerns. They may have a cause-and-effect relationship or be a coincidence. The same illness can sometimes lead to another condition, or the medication used to treat one condition can have an adverse reaction that leads to a new disease.

It’s unsurprising to learn that people with lower socioeconomic status are more likely to develop health conditions and suffer from more of them. But what’s more concerning is that people with a high level of comorbidities have a lower quality of life and are at increased risk for death.

Pharmacists need to recognize the existence of comorbidities and know how they affect a patient’s medication regimen. This is because patients with comorbidities often require more than just medication therapy management; they need complex care plans to effectively manage their diseases and reduce the risks of adverse reactions. Fortunately, various tools are available to help pharmacists identify and monitor comorbidities in their patients.

Adherence

Taking medications as a physician prescribes is an important part of patients’ care. However, non-adherence takes the lives of 125,000 Americans and costs the healthcare system $300 billion a year.

Adherence refers to the patient’s ability and willingness to conform to recommendations for drug treatment, diet, or lifestyle changes agreed upon with a clinician. Adherence is sometimes referred to as compliance or concordance. However, these terms are less frequently used because they emphasize that external factors affect medication-taking behavior, a complex process involving many internal and environmental elements.

The nature of diseases influences medication adherence, the efficacy and tolerability of medicines, as well as by patient-related characteristics and the structure of the healthcare system. Adherence studies vary considerably, reflecting these differences and the lack of consensus regarding definitions, methodologies, and adherence measures. Moreover, commitment differs across disease categories, with some brands of medicines performing much better than others in a particular condition.

Monitoring

Medication therapy management (MTM) is a patient-centered approach to optimizing drug regimens and helping patients understand their medications. However, MTM has a narrow focus and only looks at a patient’s list of prescription and over-the-counter drugs to assess whether their remedies are effective.

Suboptimal medication therapy costs the health system billions yearly in unnecessary illness, death and poor quality of life. Many of these outcomes are avoidable.

Read Also: FAQ About Physical Therapy

A key component of an MTM program is monitoring, which includes identifying and reporting the following issues:

MTM services are a foundation of our drug management programs that help improve healthcare outcomes and limit overall health costs. MTM is part of your Medicare plan benefits. If you have one of our Medicare Advantage plans with drug coverage, including Medicare Part D, you may qualify to meet with a clinical pharmacist to review your medications and conditions. You can determine your eligibility by calling your plan’s customer service number. If you have Medicare Part D, your health plan determines your MTM eligibility every quarter.

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