Introduction
As a group medical practice pioneering in Regenerative Medicine that focuses on helping patients with chronic and complex conditions nationwide, we prioritize performing Medication Therapy Management (MTM) as part of clinical care management. Our Clinical Pharmacist reviews all medications prescribed by all prescribers providing care to the patient, and any over-the-counter, supplements and herbal products the patient may be taking to identify and address medication problems. Problems may include medications not being used correctly, duplication of medications, unnecessary medications, and the need for medication(s) for an untreated or inappropriately managed condition.
Prevalence of medication-related problems are a significant public health issue within the healthcare system. Incidence estimates suggest that more than 1.5 million preventable medication related adverse events occur each year in the United States, accounting for an excess of $177 billion in terms of medication-related morbidity and mortality.
Pharmacogenomics Applications is a new and emerging medication therapy management service provided by Pharmacists, where they play a role in the interpretation and application of a patient’s genetic information to optimize a patient’s response to certain medications. “Predicting” patients’ response to some therapies, dosing medications based on genetic test results, predicting which patients will experience adverse reaction to selected therapies, and making informed recommendations to prescribers on the best treatments for that individual patient that maximize effectiveness while minimizing risk. Pharmacogenomics has also been referred to as “personalized medicine.”
Medication Therapy Management (MTM) is aimed to address issues that may arise due to polypharmacy, preventable adverse drug events, medication adherence, and medication misuse.
These range of services are provided to individual patients in order to optimize therapeutic outcomes, help patients get the most benefit from their medications and detect and prevent medication problems. MTM provided by clinical pharmacists (the medication therapy expert) consists of a review of all medications prescribed by all prescribers providing care to the patient, and any over-the-counter and herbal products the patient may be taking to identify and address medication problems. Problems may include medications not being used correctly, duplication of medications, unnecessary medications, and the need for medication(s) for an untreated or inappropriately managed condition.
In-depth, medication-related education, consultation, and advice provided to patients, family and/or caregivers will help ensure proper use of medications. Collaboration with the patient, physician, and other health care providers to develop and achieve optimal goals of medication therapy.
MTM includes five core elements:
- Medication therapy review
- Personal medication records
- Medication-related action plan
- Intervention or referral
- Documentation and follow-up
MTM is especially effective for patients with multiple chronic conditions, complex medication therapies, high prescription costs, and multiple prescribers. MTM can be performed by Pharmacists with or without a Collaborative Practice Agreement (CPA).
Impact of MTM in Clinical Outcomes: MTM is thought to influence a wide variety of outcomes. Two of the most common outcomes measured in MTM studies are drug therapy problems identified and drug therapy problems resolved.
Clinical Pharmacists at Regenerative Medical are the experts in the therapeutic use of medicines in care management and may perform various tasks including: evaluating medication therapy and making appropriate recommendations to patients or health practitioners. They perform functions beyond fundamental dispensing and order-processing activities. This typically involves optimizing medication selection, dosing, and monitoring.
FREQUENTLY ASKED QUESTIONS
1. Why do I need MTM?
The impact of MTM on health care utilization, intermediate health outcomes, and patient-centered outcomes may derive from identification and resolution of drug therapy problems, including improved medication adherence, fewer drug-related adverse events, and more efficient coordination of care.
2. Am I eligible for MTM?
(1) You are taking 2 or more prescribed medications
(2) You are taking take any ‘high risk’ medications
(3) You are diagnosed with have 2 or more chronic conditions
(4) You have undergone a transition of care, or other factors that are likely to create a high risk of medication-related problems.
3.What should I expect in my MTM consultations?
- A comprehensive medication review to identify, resolve, and prevent medication related problems, including any negative drug events
- Development of a medication treatment plan.
- Training and education that will help you better understand your medications and how to use them.
- Monitoring and evaluating your response to medications, including safety and effectiveness.
- Documentation of the care delivered and communication with your primary care physician.
4. Who will be performing the MTM ?
It is done by our Clinical Pharmacist who has a doctorate in pharmacy.
5. How often do I need MTM?
The timelines vary depending on various factors: unless there are significant changes in medications, or newly diagnosed conditions, most patients need a medication review every 3 to 6 months.
6. Is MTM covered by my Insurance?
MTM is covered by a few insurances depending on the specific plans with a minimum out of pocket. Some of them are: Medicare, Anthem / Premera, BlueShield / Regence, Cigna.
7. Does MTM require prior-Authorization from my insurance?
No, MTM service does not require prior-Authorization from your insurance. However, the benefit coverage varies depending on your insurance plan.
8. Is there a copay or an out of pocket?
The out of pocket varies based on your insurance. A minimum of $20 – $25 / visit
9.Can I use MTM service in case I don’t have insurance?
Yes, the cost is $50 – $75 depending on the consultation time with the Clinical Pharmacist.
10. How do I prepare for an MTM visit ?
Keeping the current prescription medications, OTC (over-the-counter medications) supplements, herbs and nutraceuticals ready to go over with our Clinical Pharmacist in-office or over the phone.
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