Magazine article Drug Topics

MTM Opens Door to Direct Patient Care

Magazine article Drug Topics

MTM Opens Door to Direct Patient Care

Article excerpt

With the move toward coordinated care systems, a "brave new future" will be shifting pharmacists' roles from dispensing to direct clinical practice, says Terry Mclnnis, MD, MPH, co-leader of the Medication Management Taskforce for the Patient-Centered Primary Care Collaborative. PCPCC is a nonpartisan advocacy group that promotes the Joint Principles of the Patient-Centered Medical Home, a Washington, D.C.-based initiative sponsored by the American Academy of Family Physicians, the American Academy of Pediatrics, the American College of Physicians, and the American Osteopathic Association.

Medication therapy management (MTM) will be key in new systems such as accountable care organizations and patientcentered medical homes, where the goals are to pay attention to the patient, coordinate care, and ensure that the system is helping to control their diseases, she said.

According to Mclnnis, with payment reform, quality rather than volume will be emphasized. Lower hospitalization rates will be encouraged; unneeded procedures and duplicative diagnostics will not.

Physicians and pharmacists, she said, will "be measured and compared based on patient outcomes and what impact you can have to the total system such as reductions in hospitalizations and reductions in ER visits."

More than drug review

Mclnnis, who is president of Blue Thorn, Mc, a healthcare consulting services company, spoke during a recent webinar sponsored by UPvAC, a nonprofit organization that promotes healthcare quality through accreditation, education, and measurement programs.

She warned that if pharmacists are only reviewing the drug list and are not aware of patients' clinical conditions, it will be impossible to determine any untreated indications or subtherapeutic dosages, saying, "Some of these other issues are large in terms of drug-related problems in an ambulatory setting."

Sixty-five percent of pharmacists are currently in dispensing roles, she said, but developments such as robotics and the expanding role of pharmacy technicians could free up a "whole new workforce of community pharmacists" to work in direct patient care. At the same time, Mclnnis noted, dispensing fees are decreasing.

The steps to MTM include finding the actual patterns of use, ascertaining where patients are clinically and where they need to be, and then assessing each medication in that order.

This requires direct interaction with each patient, she pointed out. Whether a physician or a pharmacist interacts with the patient, an individualized care plan must be developed to achieve treatment goals, she said. …

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