Medication Therapy Management (MTM)
Following the late 2003 passage of the Medicare Prescription Drug Improvement and Modernization Act, the pharmacy profession had a need to act quickly to define MTM so that a consensus definition would be available as regulations implementing the Medicare Part D benefit were being written. The American Pharmacists Association facilitated this process by convening a broad working group of members and other involved parties to draft a preliminary definition. The Pharmacy Practice Activity Classification was used to check elements of the definition for consistency with services being offered in a wide variety of settings. A profession-wide stakeholders conference was then convened with representatives from each of 11 national pharmacy organizations. This group, following a daylong meeting in late May 2004 and several weeks of e-mail messages and conference calls, finalized the MTM definition, which was then approved by the chief executive officers of all 11 groups. The APhA Foundation facilitated the consensus development process, recorded the discussion, and documented the implications of the definition.
To describe events leading to development of a profession-wide consensus definition of medication therapy management (MTM) and attendant programs and services and present the document (definition, services, and program requirements) resulting from the process.
To address the formidable challenge of achieving professional consensus on a practical and viable MTM definition, APhA established three core objectives:
- To ensure that the MTM definition was inclusive of the types of services and programs that are or can be provided in diverse pharmacy practice segments
- To include in the MTM document a description of examples of services that can be implemented by a majority of pharmacy practitioners
- To engage all national professional pharmacy organizations in development of a consensus MTM definition that all would support and use as they worked for favorable regulatory language and needed changes in the health care delivery system
Medication Therapy Management is a distinct service or group of services that optimize therapeutic outcomes for individual patients.
Medication Therapy Management services are independent of, but can occur in conjunction with, the provision of a medication product.
Medication Therapy Management encompasses a broad range of professional activities and responsibilities within the licensed pharmacist's, or other qualified health care provider's, scope of practice. These services include but are not limited to the following, according to the individual needs of the patient:
- Performing or obtaining necessary assessments of the patient’s health status
- Formulating a medication treatment plan
- Selecting, initiating, modifying, or administering medication therapy
- Monitoring and evaluating the patient’s response to therapy, including safety and effectiveness
- Performing a comprehensive medication review to identify, resolve, and prevent medication-related problems, including adverse drug events
- Documenting the care delivered and communicating essential information to the patient’s other primary care providers
- Providing verbal education and training designed to enhance patient understanding and appropriate use of his/her medications
- Providing information, support services, and resources designed to enhance patient adherence with his/her therapeutic regimens
- Coordinating and integrating medication therapy management services within the broader health care management services being provided to the patient
For more background, visit the APhA website.
Foundation Staff Involved
Benjamin Bluml, APhA Foundation, SVP of Research and Innovation
Through the extraordinary efforts of the numerous organizations and participants, the MTM Services Definition is one that is applicable within diverse pharmacy practice segments, whose services are feasible for a majority of practitioners to implement, and whose elements are supported by a profession-wide consortium of 11 national professional pharmacy organizations.
Read the white paper here.
Looking to the Future
This historic achievement was the first step on a journey to find the best ways to effectively deliver MTM services to patients. The consensus definition was included in regulations related to the the Medicare Modernization Act of 2003.