Academic journal article American Journal of Pharmaceutical Education

Medication Therapy Management Services Provided by Student Pharmacists

Academic journal article American Journal of Pharmaceutical Education

Medication Therapy Management Services Provided by Student Pharmacists

Article excerpt

Medication therapy management (MTM) was established by the Center for Medicare and Medicaid Services (CMS) under the Medicare Modernization Act of 2003 with the goal of producing optimal therapeutic outcomes and reducing adverse drug events for Medicare Part D beneficiaries. (1) Pharmacist involvement inpatient care improves health outcomes and medication adherence rates while reducing adverse drug events. (2,3) Community pharmacists, in particular, are in an ideal position to provide MTM services, as they have the opportunity to interact with their patients every 1 to 3 months when patients come into the pharmacy to refill their prescriptions. (2) Although there are some examples of successful MTM community pharmacy practices, the provision of MTM services in community pharmacies is not widespread nor is it considered standard practice. (4) In 2010, the American Pharmacists Association (APhA) found that one of the greatest barriers to pharmacists providing MTM services was not having adequate time. (5) Pharmacists not providing MTM reported that lack of time, insufficient staffing levels, and a high level of dispensing activities were major challenges. (5)

According to the Accreditation Council for Pharmacy Education (ACPE) standards, required advanced pharmacy practice experiences (APPEs) should emphasize the need for continuity of care throughout the health care delivery system. (6) One of the characteristics recommended for community APPE sites is that they provide medication therapy management and patient care services for diverse populations. (6) Community pharmacists' inability to implement MTM services means that students do not have opportunities to observe or be involved in the development, implementation, and provision of MTM services during practice experiences. (7) Dugan proposed in 2006 that student pharmacists on APPEs could enhance community pharmacy services. (8) Incorporating MTM in the curriculum and using active-learning strategies may improve student confidence and their perceived ability to provide these services. (9,10) However, to our knowledge, there have been no studies that examined implementation and documentation of MTM services provided by student pharmacists to patients in the community pharmacy setting through the experiential curriculum.

The authors, all faculty members at Western University of Health Sciences College of Pharmacy, proposed incorporating MTM into the college's experiential program as a possible solution to some of the concerns mentioned. The authors are part of a collaborative research team at the institution called the Community Pharmacy Research and Education or CORE group whose mission is "to advance community pharmacy practice to improve patient outcomes and pharmacist professional recognition."

APPEs at the college take place over 15 months, starting in the second half of the third year of the PharmD program. Students complete seven 6-week APPEs, followed by a final 12-week advanced elective course just prior to graduation. Students can choose 1 of 3 "tracks" for the 12-week APPE: institutional setting, community pharmacy, or independent pharmacy ownership. These tracks are designed to provide students with an advanced, more concentrated experience in a practice setting in which the student is considering working after graduation. The goals of the community pharmacy track are to ensure that the student pharmacist receives adequate exposure to pharmacy practice and is prepared to perform pharmacist-in-charge duties, MTM, and other direct patient care services. The independent pharmacy ownership track is designed to offer specialized training in community pharmacy ownership through onsite experience, self-directed learning, and team work in addition to completing the pharmacist-in-charge and MTM modules.

An MTM project was added to the APPE community pharmacy and independent pharmacy ownership tracks in 2009 to determine the feasibility of implementing MTM services at the pharmacies, as well as to examine students' confidence levels in providing MTM. …

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