Pharmacists Practice Medication Therapy Management to Improve Patient Safety

‍Taking the right medicine at the right time can be a challenge for essential hospitals’ low-income and underrepresented patients, who often experience low health literacy, language and transportation barriers, poor social support, and other social determinants that inhibit medication adherence.

Inappropriate medication use not only can jeopardize a patient’s health but also takes a toll on the nation’s health care system, as a whole. Statistics show poor medication adherence contributes to more than $500 billion in avoidable health care costs, around 125,000 potentially preventable deaths, and up to 25 percent of hospitalizations each year in the United States.

As one solution, hospitals turn to medication therapy management (MTM), a service or group of services offered by licensed pharmacists and physicians to help patients optimize their therapeutic outcomes through improved medication use.

A rural health system in the Midwest offers one example of the difference MTM can make. A staff pharmacist reviewed the chart of a patient with rheumatoid arthritis and noticed their rheumatologist made a note to discontinue one of three medications originally prescribed. Yet, the patient failed to stop. The pharmacist immediately contacted the patient’s physician to confirm the patient should not be taking this medication, which quickly resolved the problem and headed off additional issues with the patient’s treatment plan.

“We have wonderful examples of the ways pharmacists have led MTM services, from stopping a patient taking additional medication that was discontinued for months to catching a near anaphylactic reaction to a medication, and working with the patient and the physician to change to a medication that was on the patient’s health plan formulary,” said Tony Cresco, PharmD, director of specialty pharmacy at Clearway Health, a corporate affiliate of America’s Essential Hospitals. Clearway Health collaborated with the Midwest health system on MTM specialty pharmacy services through in-clinic support from specialty pharmacists and patient care liaisons.

MTM is especially important in a rural setting, where patients might get care from many different providers and where there might not be enough providers on hand to spend time on a medication review with each patient.

During Clearway Health’s nearly three-year partnership with the Midwest health system, its pharmacists overseeing patient care have made more than 630 MTM recommendations to providers, many of which avoided potentially serious medication interactions or other patient safety risks.

MTM Brings Pharmacists, Providers, and Patients Together

Specialty pharmacists embedded into a health system to practice MTM can help prevent these events by communicating directly with physicians and other members of the care team. Pharmacists can speak one-on-one with patients, helping them to understand their medication regimen, manage potential adverse effects, provide counsel on side effects, ensure the patient is planning for refills, and check-in periodically to ensure compliance. These services also help ensure patients receive all pertinent lab tests while on medications and that they discuss current medications and potentially more effective options, if available.

Collaborative Practice Agreements

A collaborative practice agreement (CPA) is a formal agreement between a licensed physician and a pharmacist. The physician diagnoses and oversees the care of their patients and refers them to a pharmacist for patient assessments; counseling and referrals; ordering laboratory tests; administering drugs; and selecting, initiating, monitoring, and adjusting drug regimens.

CPAs foster an environment where pharmacists help to reduce fragmentation of care, decrease health care costs, and improve patient outcomes within a health system. When pharmacists can prevent adverse events and ensure patients adhere to their medications, health care outcomes improve and costs for payers and the health care system decrease. A recent study by Virginia Commonwealth University (VCU) found pharmacists could save millions of lives and more than $1 trillion in health care costs over 30 years if they were given more leeway to help patients with chronic care management and care coordination.

To read the full published article in America's Essential Hospitals' blog, Essential Insights, click here