Integrating Pharmacist MTM Services into Medical Clinics as Part of a Health Department Partnership Project.

INTRODUCTION: Medication therapy management (MTM) services are an essential way for pharmacists to provide cognitive services to patients and receive reimbursement. Traditional MTM delivery has been identified as suboptimal, often done by telephone without any provider-patient relationship. New ways for delivering MTM need to be explored to optimize the pharmacist's role in this area and help establish the pharmacist as an essential part of the interprofessional team. METHODS: A local public health department partnership with regional medical offices integrated pharmacist MTM services on site as part of patients' routine medical care. Referral criteria were established to identify patients who would be good candidates for services. Efforts were made to provide the initial consultation in the medical office, with follow-up consults being based upon patient preferences. RESULTS: Over a 3-year period, 180 patients received 361 pharmacy MTM consultations, averaging 40 minutes in length. A comprehensive medication review was performed on 87% of patients receiving these consults. The pharmacy team identified 719 medication-related problems, and improved participating patients' adherence rates. Pharmacy recommendations were accepted as is or modified by providers 55% of the time. Patients reported high satisfaction with the pharmacy services. CONCLUSIONS: A novel pharmacist MTM program integrated into provider offices demonstrated a positive impact on the clinics and on patients served, and successfully overcame barriers to successful MTM completion.

A novel advanced pharmacy practice experience training model focused on medication therapy management delivery within provider offices.

BACKGROUND AND PURPOSE: Pharmacist-delivered medication therapy management (MTM) services are an important part of practice, and students should be trained in MTM provision. Current MTM utilization falls short of the potential benefits that pharmacists could provide, and there are barriers to successful MTM completion. New MTM models need to be explored to demonstrate the pharmacist's role on the medical team and to provide models for cost saving to insurers. EDUCATIONAL ACTIVITY AND SETTING: This manuscript describes a novel grant-funded MTM model supported by fourth year pharmacy students in partnership with several medical clinics. Qualifying patients receive MTM services in the provider office. Students are responsible for maintaining day-to-day operations of the MTM program. FINDINGS: Twe pharmacy students completed their MTM training through this model between April 2016 and September 2017. 123 patients received MTM services, with the average time spent with patients estimated at 41 min. A total of 238 patient encounters were provided. Poor adherence, inappropriate drug dose/dosage form or frequency, and patient side effects were the most common problems addressed. Students reported high satisfaction with this model. DISCUSSION: Providing MTM services, directly in the medical clinic, represents an innovative model of care where students have multiple interprofessional interactions. The extended period of time spent with patients is not supported by reimbursement rates, suggesting an expansion may be appropriate. Further cost analyses and health outcomes need to be collected to justify this increased expense. SUMMARY: This MTM model represents an important alternative to current practice and promotes interprofessional collaboration.