Medication Therapy Management (MTM), is defined by the American College of Clinical Pharmacy, as a range of services provided to individual patients to optimize therapeutic outcomes and detect and prevent costly medication problems.
Before we discuss where we believe the future of MTM is trending, let’s first look back at the history of the program to understand the progress made to date.
A brief history of medication therapy management
The term “medication therapy management” first gained official recognition from the federal government in the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. Pharmacists, however, provided similar services under the name “pharmaceutical care” dating back to the 1990s.
Names and terminology aside, the goal has always remained the same: take an in-depth look at the full spectrum of medications (prescription and non-prescription) taken by a patient, analyze their interactions, identify gaps in care, and create solutions to prevent current and potential future health issues through proper medication use.
It quickly becomes easy to see why clinical pharmacists are the most natural fit to deliver such a service. They’re the top-educated clinicians in the realm of medications, they are more accessible to most patients than a primary care doctor, and they are also viewed as some of the most trustworthy healthcare professionals.
Significant changes to medication therapy management
While the goal of MTM hasn’t deviated much since its inception, the practice itself has grown and changed over the years.
MTM availability
Medication therapy management has the potential to be valuable for any patient, regardless of age, condition, or demographic. Yet despite the clear benefits to a patient’s health and ultimate health outcomes, the service continues to be most offered to seniors. In fact, all Medicare Part D plan sponsors must offer a medication therapy management program to their members.
Technology-enabled service delivery
While MTM services were first delivered in person directly from pharmacists to patients, times have changed. With our nation’s pharmacist workforce under more burden than ever before, time nor resources allow this to be a sustainable approach any longer. This is why many MTM programs are now powered by new technology platforms, such as Aspen RxHealth. Aspen RxHealth partners with health plans to serve their members through the nation’s largest community of pharmacists. This means that no matter how large the MTM needs of a health plan, Aspen RxHealth has the capacity to ensure members get access to the care they need.
Improved care team coordination
Powered by technological innovation, MTM programs are now able to have greater communication and coordination among members of each patient’s care team. For example, following a comprehensive medication review (CMR) between an Aspen RxHealth pharmacist and a patient, the Aspen RxHealth platform handles notifying the prescribing physician to ensure any identified medication errors are properly addressed.
What MTM research reveals
Is there real-world evidence for MTM’s effectiveness? Does it really help patients live healthier lives through better medication management? Fortunately for the healthcare system and for patients, the answer to both of those questions is “yes”.
Benefits of MTM in chronically ill patients
Patients with one or more chronic conditions tend to be the highest utilizers of healthcare services in the United States. And it’s not surprising why.
Imagine a patient who suffers from diabetes, hypertension, and high cholesterol. While these are three separate conditions marked by varying symptoms, they are all cardiovascular diseases that influence one another and ultimately deteriorate the patient’s standard of living. These conditions make it more likely that this patient might need to utilize costly healthcare services frequently. This patient would be a perfect candidate for an MTM program.
Now imagine that this patient completes a comprehensive medication review with a clinical pharmacist. During the CMR, the pharmacist discovers that the patient’s insulin dosage is too low, leading to elevated blood sugar. Because of the elevated blood sugar, the patient’s blood pressure is also elevated and thus, they are at an increased risk of heart disease and stroke. Fortunately, because of the pharmacist’s intervention, the insulin dosage was identified, communicated to the prescriber, and corrected. With a new insulin dosage, the patient has their blood sugar under control and their whole-person health is improved as a result.
This isn’t purely hypothetical, though. A meta-analysis of several studies concluded that MTM is an important component of managing diabetes based on the pharmacist-led patient education, monitoring of therapy goals, and interventions made to improve the treatment plan.
Benefits of MTM for elderly patients
In our example above, it’s clear why MTM is a great way to improve the health of patients dealing with several chronic conditions. The example patient experienced significant challenges caused by several comorbidities that impacted their quality of life—now imagine that patient is 80+ years old.
That’s exactly the situation that many Medicare beneficiaries in the US find themselves in. They are elderly, often located in disparate locations, living on a fixed income, and suffering from conditions that worsen with age.
Beyond the straightforward therapeutic benefits of MTM, in these patients, MTM can also be a valuable educational tool. A common barrier to better health for Medicare patients is cost. Being on several expensive medications to manage one’s health comes with a hefty price tag, and seniors living on limited incomes sometimes simply cannot afford to foot the bill. In a situation like this, MTM could be a great solution for the patient. During the consultation, the pharmacist would be able to identify the barrier (cost) and provide educational information to the patient about financial assistance programs available to help cover their medication expenses. They could also make recommendations to the prescriber about switching to lower-cost generic medications.
During the same consultation, the pharmacist could help the patient set health goals and create an action plan to achieve those goals. Steps as simple as improving diet and increasing physical activity can make all the difference in the world to elderly patients looking for any benefit they can find for their health.
Best of all, through technology-enabled platforms such as Aspen RxHealth, the pharmacist was able to provide this potentially lifesaving service remotely, eliminating the need for the patient to find transportation to a pharmacy or provider office.
The future of medication therapy management
So, what does the future of medication therapy management look like? We'd like to think it’s bright.
Improving lives for pharmacists and patients alike
The patient benefits of MTM are clear—it's a fantastic tool for increasing patient education, medication adherence, and ultimately improving health outcomes. But a less frequently spoken about benefit is the boost to pharmacists’ quality of life.
For many decades, pharmacists have been healthcare’s underdogs: unappreciated, undervalued, and underutilized. They’ve been relegated to behind the counter in pharmacies to dispense medications, serve long lines of impatient customers, and manage pharmacy staff. This dynamic leaves very little time for pharmacists to do what they love—utilize their medication skills and knowledge to improve patient lives through medication optimization.
Fortunately, a heightened focus on MTM programs in recent years is creating new opportunities for pharmacists to use the tools they gained in school in more effective ways than ever before. Aspen RxHealth pharmacists enjoy the ability to work remotely from anywhere in the US with an internet connection and help patients with a litany of medication optimizations.
Through Aspen RxHealth and other remote models, pharmacists are enjoying greater career satisfaction, more flexibility, and the freedom to make time for what matters most to them—all while doing more fulfilling work.
Outsourcing MTM plans to a trusted partner
For all their benefits, MTM programs aren’t easy or cheap to spin up. Many health plans, especially smaller regional plans, may find that building MTM programs from the ground up simply isn’t doable from a budgetary and timing standpoint.
In the future, we expect to see more and more health plans outsourcing their previously in-house MTM programs to trusted vendors such as Aspen RxHealth. Working with us means that health plans no longer must hire, train, and retain an entire call center full of pharmacists. They can simply contract with Aspen RxHealth, get their members the care they need, and access a full reporting suite to stay apprised of the program’s success.
Whether you’re a pharmacist looking to escape dispensing in a retail environment or a health plan pharmacy leader looking for a competitive edge in the MTM space, Aspen RxHealth is a fit for you. Sign up for the Aspen RxHealth Pharmacist Community or connect with us to get started.