94:
identify and fix drug therapy problems common in chronic diseases such as nonadherence, duplicate therapy, or sub-optimal therapy. The pharmacist or provider will contact the patient to ensure adherence, identify potential problems with the therapy, and make any appropriate recommendations to the prescriber. The provision of TMR services to patients with chronic diseases has been shown to decrease the number of inpatient admissions per 1000 patients by about 50 admissions per 1000 patients.
85:. The patient must be provided a medication action plan with a list of their medications, directions, and any steps they need to take to improve their therapy (such as using reminders, organizing, stopping old medications, etc). Most comprehensive medication reviews result in pharmacist intervention to recommend changes to therapy to a doctor, and/or recommendations to the patient to improve adherence/efficacy of their medications.
81:. A pharmacist or other provider conducting a CMR will use information from various sources, such as the pharmacy fill records, the patient's pill bottles, a patient interview, and/or discussion with caregivers to identify potential improvements that can be made in the patient's therapy. The pharmacist will then make any appropriate recommendations to the patient's doctor, as well as document their findings in a format similar to a
36:
reducing waste due to unused medicines, looking for any side effects, and providing education on how to manage any side effects. The process that can be broken down into five steps: medication therapy review, personal medication record, medication-related action plan, intervention and or referral, and documentation and follow-up.
67:
plans to include an MTM program, which led to an expansion of services offered. MTM services are provided free to eligible patients enrolled in a plan. As of 2019, to be eligible a patient must have at least two (or three, for some plans) chronic conditions, take multiple drugs covered by Part D, and
168:
There have been concerns over abuse of the system, whereby multiple pharmacies are using the system to charge the £28 fee for each 10- to 15-minute MUR, and pressuring pharmacists to meet targets for the number carried out, with the review more of a tick-box exercise than a benefit for the patient.
76:
As part of the minimum required services, plans must provide for a comprehensive medication review (CMR) once per year, usually conducted by a pharmacist. Per CMS guidance, the goal of the CMR is to "improve patients’ knowledge of their prescriptions, over-the-counter (OTC) medications, herbal
35:
scientists that aims to improve outcomes by helping people to better understand their health conditions and the medications used to manage them. This includes providing education on the disease state and medications used to treat the disease state, ensuring that medicines are taken correctly,
93:
A targeted medication review (TMR, also called targeted intervention program or TIP) is a required service for eligible patients that focuses on a specific medication or disease state and is conducted once every three months. The goal of a TMR program is to improve adherence to medication and
118:(NHS). An MUR is an opportunity for patients to discuss their medicines with a qualified pharmacist. An MUR is a free NHS service that is held in a private consultation room at a local pharmacy. It is not meant to replace the role of the general practitioner but rather provide:
519:
Rivera, Jasmine; Shcherbakova, Natalia; Vala, Christine; Capoccia, Kam (December 2019). "Community pharmacists' interventions and documentation during medication therapy management encounters delivered face-to-face versus via telephone: The devil is in the details".
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are predicted to exceed a preset amount in annual out of pocket costs for their covered Part D drugs (set at $ 3,967 in 2018 and $ 4,044 in 2019). Plans are permitted to expand MTM eligibility to patients not meeting the minimum required criteria if they so choose.
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therapies and dietary supplements, identify and address problems or concerns that patients may have, and empower patients to self manage their medications and their health conditions." The CMR is conducted in an interactive manner either in person or through
343:
Greer, N; Bolduc, J; Geurkink, E; Koeller, E; Rector, T; Olson, K; MacDonald, R; Wilt, TJ (October 2015). "Pharmacist-Led
Chronic Disease Management: A Systematic Review of Effectiveness and Harms Compared to Usual Care ".
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Pharmacies in the United kingdom are paid £28 for each
Medicines Use Review undertaken, up to a maximum of 400 per pharmacy, per year. At least 70% of patients must be in one of the four target groups:
645:
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The introduction of pharmacists into GP surgeries means that the practice pharmacists can do more to ensure that reviews are carried out where necessary.
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Pestka, Deborah L.; Zillich, Alan J.; Coe, Antoinette B.; Farris, Karen B.; Adeoye, Omolola A.; Snyder, Margie E.; Farley, Joel F. (May 2020).
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Viswanathan, Meera; Kahwati, Leila C.; Golin, Carol E.; Blalock, Susan; Coker-Schwimmer, Emmanuel; Posey, Rachael; Lohr, Kathleen N. (2014).
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The medication therapy review has the pharmacist review all of the prescribed medications, any over the counter medications, and all
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Pellegrino, AN; Martin, MT; Tilton, JJ; Touchette, DR (2009). "Medication therapy management services: definitions and outcomes".
709:
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470:"Comparison of Medication Therapy Management Services and Their Effects on Health Care Utilization and Medication Adherence"
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310:. The American Pharmacists Association and The National Association of Chain Drug Stores Foundation. March 2008.
565:"Nationwide estimates of medication therapy management delivery under the Medicare prescription drug benefit"
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Ferries, Erin; Dye, Joseph T.; Hall, Benjamin; Ndehi, Lilian; Schwab, Phil; Vaccaro, Jamieson (June 2019).
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268:. American Pharmacists Association and National Association of Chain Drug Stores Foundation. March 2008.
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with cardiovascular disease or risk factors, who are prescribed four or more regular medicines.
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an individual is taking. This allows the pharmacist to look for any duplications or dangerous
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47:. This service can be especially valuable for people who are older, have several
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667:"Have medicines use reviews come to represent profit over patient care?".
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Medication
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263:"Medication Therapy Management in Pharmacy Practice Version 2.0"
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114:. It is part of the current contract pharmacies hold with the
51:, take multiple medications, or are seen by multiple doctors.
439:"Part D: Getting to Know Medication Therapy Management (MTM)"
285:. Centers for Disease Control and Prevention. 18 January 2018
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305:"Leadership for Medication Therapy Management Version 2.0"
199:"Pharmacist-Led Medication Therapy Management Innovations"
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in the United
Kingdom, is a service provided typically by
368:"CMS proposes requiring expansion of Part D MTM benefits"
283:"Community Pharmacists and Medication Therapy Management"
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There have also been cases of falsification of figures.
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taking certain high risk medicines on the national list
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399:. Agency for Healthcare Research and Quality (US).
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474:Journal of Managed Care & Specialty Pharmacy
125:Give extra information on what medicines are for
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522:Research in Social and Administrative Pharmacy
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346:VA Evidence-based Synthesis Program Reports
131:Identify problems associated with medicines
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425:Center for Medicare and Medicaid Services
418:"Fact Sheet Summary of 2019 MTM Programs"
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322:"Medication Therapy Management Services"
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648:. Eastern Daily Press. 6 January 2017
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203:AHRQ Health Care Innovations Exchange
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324:. American Pharmacists Association
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106:is an advanced service offered by
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128:Discuss side effects of medicines
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230:10.2165/00003495-200969040-00001
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621:"Medicines Use Reviews (MURs)"
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669:The Pharmaceutical Journal
581:10.1016/j.japh.2019.12.002
89:Targeted medication review
446:National Council on Aging
104:medicine use review (MUR)
677:10.1211/PJ.2013.11124150
116:National Health Service
205:. September 9, 2016.
179:Adherence (medicine)
393:"Executive Summary"
41:dietary supplements
21:medicine use review
19:, generally called
372:www.pharmacist.com
49:chronic conditions
528:(10): 1447–1451.
45:drug interactions
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185:References
108:pharmacies
79:telehealth
685:2053-6186
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671:. 2013.
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546:S2CID
442:(PDF)
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242:S2CID
218:Drugs
681:ISSN
654:2017
632:2019
595:PMID
538:PMID
502:PMID
350:PMID
330:2018
291:2018
234:PMID
673:doi
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