All too often, patients receive treatment for chronic conditions, are given a prescription, and sent on their way. In some cases, the patient or their family are on top of a routine medication, making sure all medications and treatments are being taken regularly and on time. But there are many times when extra support is essential for proper medication adherence and ensuring positive outcomes.
Medication therapy management, or MTM as most know it, is a type of care typically performed by clinical pharmacists that aims to ensure patients receive the proper treatment. MTM improves patients’ health by ensuring proper medication management and, as a result, better medication adherence. So, what is the role of a clinical pharmacist when it comes to MTM, and what challenges do they face?
The goal of medication therapy management
MTM makes sure that patients have the right medications for their health conditions and that they’re getting the maximum benefits of prescribed medications. MTM also detects and prevents costly problems such as adverse drug events (ADEs), which cost our healthcare system between $1.56 and $5.6 billion each year in preventable care.
While anyone taking medication could benefit from an MTM program, the greatest value is often seen among patients with chronic conditions who take multiple medications for chronic conditions, commonly referred to as polypharmacy. These individuals are typically older adults, often Medicare-eligible, and managing complex health issues that require careful coordination of therapies. In these cases, an MTM pharmacist provides essential, personalized support to ensure that medication regimens are safe, effective, and aligned with the patient’s overall care plan.
MTM services are especially beneficial in situations such as:
- Patients taking five or more medications regularly increase the risk of drug interactions, side effects, or duplicate therapies.
- Patients with multiple chronic conditions, such as diabetes, hypertension, COPD, or heart failure.
- Recent transitions of care, such as hospital discharge, when medication regimens are often changed or added to.
- Patients prescribed high-risk medications, including opioids, anticoagulants, or medications with narrow therapeutic ranges.
- Signs of non-adherence or confusion about how or when to take medications.
- Limited health literacy or cognitive challenges, where pharmacist guidance can improve understanding and outcomes.
- Cost-related barriers, such as unaffordable medications or a need for lower-cost therapeutic alternatives.
In these situations, the consultative and empathetic approach of an MTM pharmacist can make a large difference, both in improving a patient’s quality of life and in reducing healthcare disparities or unnecessary healthcare utilization.
The role of a clinical MTM pharmacist
You might wonder, “Why can’t physicians counsel patients on the medications they are prescribing?” Consider a patient who has been prescribed multiple medications across multiple care delivery sites. Perhaps some medications were prescribed in the primary care physician’s office, some in the emergency room, and some in an urgent care setting.
Because all of these medications have been prescribed by different physicians for different reasons, it’s challenging for one physician to counsel the patient on all of them. Yet, that does not mean the patient doesn’t deserve the care and attention.
Enter— the clinical pharmacist.
Patients with multiple chronic conditions often have several specialists to help them manage their health, perhaps a cardiologist for high blood pressure, a gastroenterologist for irritable bowel syndrome, and a rheumatologist for an autoimmune disorder. Shouldn’t patients have a medication specialist focused solely on ensuring maximum safety and benefit of their medications?
Core responsibilities of an MTM pharmacist
The responsibilities of MTM pharmacists extend beyond traditional dispensing functions to include high-touch, clinical services tailored to individual patient needs. This often includes:
- Comprehensive medication reviews (CMRs): MTM pharmacists assess each patient’s full medication regimen–including prescription, over-the-counter, and herbal products–to identify potential drug therapy problems, duplications, or adverse interactions.
- Medication action plans (MAPs): Based on the review, pharmacists develop a personalized plan that outlines actionable steps the patient can take to optimize therapy and ensure safe medication use.
- Identifying and resolving medication-related problems: MTM pharmacists work closely with prescribers to recommend changes in therapy when issues such as non-adherence, cost barriers, or therapeutic duplication are identified.
- Patient education and counseling: Patient education is essential to the success of MTM services. Pharmacists provide patients with the knowledge and confidence to manage complex regimens, understand side effects, and improve adherence.
- Clear documentation and communication: MTM pharmacists maintain accurate records of interventions and collaborate with other healthcare providers to ensure continuity of care.
- Preventive care support: In many cases, MTM pharmacists help identify gaps in preventive care, such as missed vaccinations or screenings, and refer patients accordingly.
Through these responsibilities, MTM pharmacists help reduce hospitalizations, lower healthcare costs, and support improved quality of life for patients managing chronic conditions.
Clinical MTM pharmacists are healthcare’s foremost medication experts. They’ve completed numerous years of education, training, and residency to fortify their expertise and understanding of how medications affect the body and one another. It’s a logical next step that a clinical pharmacist is the missing link to providing the highest possible quality of MTM services, especially to complex patients with chronic conditions.
The value of MTM pharmacists for health plans
As healthcare costs rise and population health goals become more complex, MTM pharmacists are increasingly seen as essential partners in helping health plans achieve better outcomes, reduce costs, and improve member satisfaction. As a result, MTM pharmacists are not only improving individual health outcomes but also delivering measurable value across several key areas for health plans.
Reducing avoidable healthcare costs
MTM pharmacists help health plans contain costs by preventing medication-related problems that often lead to emergency room visits, hospital readmissions, or disease progression. By proactively identifying drug therapy issues and improving adherence, MTM services can lead to fewer high-cost interventions down the line. Studies have shown that every dollar invested in MTM services can generate several dollars in healthcare savings.
Supporting medication adherence and patient outcomes
Non-adherence is a major driver of poor health outcomes and avoidable costs. MTM pharmacists take a personalized approach to understanding why a member may not be following their regimen, whether due to side effects, cost, confusion, or other barriers, and work to resolve those issues. This leads to measurable improvements in adherence rates, which are key metrics for many quality programs.
Creating a better member experience
MTM pharmacists offer personalized, one-on-one support that helps members feel cared for and empowered in managing their health. This personal touch not only improves clinical outcomes but also drives member satisfaction, another key performance area for health plans.
Aligning with value-based care goals
MTM pharmacists help health plans succeed in value-based care models by ensuring members receive the right medications at the right time, avoiding low-value or harmful therapies, and helping close care gaps. Their clinical expertise and patient-centric approach support a more efficient, outcomes-driven healthcare system.
Current challenges in medication therapy management and medication adherence
While some pharmacists work in academic settings or in hospitals, most still work in community pharmacies. Unfortunately, in the traditional setting, clinical pharmacists must often fulfill a long list of roles: inventory keeper, accountant, manager, and retail support, to name a few. It’s no wonder that pharmacists are feeling stretched thinner than ever before. And, unfortunately, pharmacist burnout has already set in for most.
Imagine pursuing a career in pharmacy with the goal of helping patients manage their health and understand their medications, only to find yourself relegated to solving staffing issues and taking inventory. While it’s important work, it’s not the work clinical pharmacists seek to provide for patients. Nor is it the reason most entered the healthcare field.
On top of their numerous other responsibilities, clinical pharmacists are also expected to complete MTM consultations in the retail setting. If you’ve been in a pharmacy recently, you’ve seen the long lines, impatient customers, and phones ringing off the hook. How can a pharmacist have an in-depth, one-on-one medication conversation with a patient under these conditions, let alone build a solid pharmacist-patient relationship? It’s simply untenable.
MTM programs also face challenges with technology interoperability. Pharmacists aren’t integrated into the healthcare information technology (HIT) infrastructure to the same extent as other clinicians. Additionally, community pharmacies often lack connectivity to the electronic health record (EHR) systems used broadly by healthcare providers. This leaves them with a lack of necessary patient information, including claims data, to deliver a high-quality consultation and, ultimately, improve patient outcomes.
Pharmacy technology empowering clinical pharmacists
Despite the challenges that exist for MTM, innovative technological solutions are changing how clinical pharmacists deliver these vital services.
Today, platforms like BeWell and Alliance by Aspen RxHealth give pharmacists newfound career freedom and allow them to reach further than ever before. After joining, our platform matches clinical pharmacists with consultation opportunities based on clinical factors, including disease state and specialty, and social factors such as language and geographic location. When consulting patients, pharmacists deliver not only MTM but also other important clinical pharmacy services like medication adherence and member education.
In fact, at Aspen RxHealth, we call it comprehensive medication management (CMM) because our pharmacists have the time and ability to take a comprehensive approach to patient care without feeling rushed or stressed. They are empowered to treat the whole patient and look beyond “checking the box.”
The best part? Remote pharmacists do this work entirely from the comfort of home on their own time. No more inventory management, staffing shortages, or long pharmacy lines. Pharmacists no longer need to feel rushed to dispense medications and deliver clinical consultations simultaneously. And the results are outstanding. Thanks to innovations and migrations towards value-based care, pharmacist-led care is finally here.
Get in touch with our team today to learn more about how innovative pharmacy technology like Aspen RxHealth is empowering clinical pharmacists to do more fulfilling work, while making more time for what matters most.
