At the completion of the self-study program, the learner will be able to:

Module 1. The Pharmacists’ Patient Care Process and MTM

• Describe the benefits of a standardized process of care.
• Explain the steps of the Pharmacists’ Patient Care Process.
• Explain the key components of medication therapy management (MTM).
• Define the five core elements of the MTM service model.
• List provisions of recent laws that have affected the evolution of pharmacists’ patient care services.
• List opportunities for providing pharmacists’ patient care services including those that were created by patient-centered medical homes, accountable care organizations, and transition of care activities.
• Discuss quality measures that can be impacted by pharmacists’ patient care services or used to evaluate these services.

• Evaluate the strengths and weaknesses of current pharmacy operations and list potential service opportunities and barriers that threaten success using a SWOT analysis.
• Write goals for providing medication therapy management (MTM) or other patient care services.
• Describe appropriate activities for pharmacy technicians, student pharmacists, and pharmacy residents involved with MTM services.
• Discuss strategies for obtaining compensation for patient care services.
• Outline the processes and key considerations of making MTM services operational and integrated with existing services.
• Identify measures to track the economic, clinical, and humanistic outcomes of an MTM service.
• Describe elements of a marketing plan for attracting patients, providers, employers, and payers to engage in MTM services in your practice setting.

• List at least seven types of medication-related problems and possible solutions.
• Describe strategies for and limitations of using clinical practice guidelines to guide the development of patient care recommendations.
• Explain strategies for assessing patients and their medication use.
• List specific patient care services that may be provided as a component of MTM services.
• Explain pharmacodynamic and pharmacokinetic changes that are common in elderly adults.
• Describe characteristics of geriatric syndromes.
• Explain the risks of medication-related problems in elderly patients, and strategies for reducing their incidence.
• Assess whether an elderly patient requires dosage adjustments for drugs that are cleared renally.

• Describe techniques that support open communication with patients, including open-ended questions and active listening techniques.
• Identify and address barriers to patient communication during MTM visits.
• Identify the stages of behavior change in the Transtheoretical Model of Change.
• Describe the communication process used in motivational interviewing.
• Describe the process for communicating with other health professionals.
• Describe the application of the pharmacist’s patient care process to the delivery of MTM services.
• Systematically review a patient’s medication regimen to assess for medication-related problems (MRPs).
• Describe a strategy for prioritizing MRPs, develop a plan to address the MRPs, and implement the plan.
• Identify components of the personal medication record (PMR) and medication-related action plan (MAP).
• Describe how to document MTM services for internal records, patient records, and communications with third parties, including the development of a PMR, an MAP, and a SOAP note.

At the completion of this activity, the learner will be able to:

• Conduct a thorough medication therapy review (MTR)
• When interviewing a patient, employ effective communication skills to overcome communication barriers
• Complete a personal medication record (PMR)
• Develop a medication-related action plan (MAP)
• Document medication therapy management (MTM) services in a manner that allows for evaluating patient progress, billing, and tracking clinical and financial outcomes
• Create a plan for patient follow-up
• Perform the following tasks, given a patient case that includes one or more medications:
  • Assess patient-specific data and issues, and interpret these findings to identify medication-related problems
  • Develop a patient problem list and a list of the patient’s medication-related problems
  • Establish goals of therapy for each medical condition and medication-related problem identified
  • Make recommendations for resolving situations in which a patient’s medications are potentially inappropriate
• Discuss the elements of an effective medication therapy recommendation to another health care practitioner
• Describe the medication use concerns and adverse drug events that are more common in elderly patients
• Account for pharmacokinetic and pharmacodynamic changes when reviewing an elderly person’s medication regimen
• List important considerations when determining the operations of an MTM service
• Identify potential payers for MTM services
• Explain how to bill for MTM services using CPT codes
• Describe strategies for marketing MTM services
• Describe emerging opportunities for delivering MTM services

At the completion of this activity, the participant will be able to:

• Conduct a thorough medication history
• Complete a personal medication record (PMR)
• Develop a medication-related action plan (MAP)
• Assess a patient's health conditions and medication use to generate a list of medication-related problems
• Prioritize a list of medication-related problems and provide recommendations to address those problems
• Appropriately document medication therapy management services provided to a patient

• Check-in
• Welcome, Introductions and Acknowledgements
• The MTM Care Process
• Break
• Patient Communication During MTM Encounters
• Cultural Sensitivity
• Managing Special Needs of Elderly Patients
• Lunch and Networking
• Case Studies
• Break
• MTM Implementation: Financial and Operational Issues
• Next Steps and Take Home Points
• Post-Seminar Assignment and Final Instructions

• Jeffrey Delafeunte, MS, FCCP, FASCP, Professor Emeritus, Virginia Commonwealth University, School of Pharmacy, Richmond, Virginia (Advisory Board Chair)
• Albert Barber, PharmD, CGP, FASCP, Consulting Pharmacist, Clinical Rx Consulting, Stow, Ohio
• JMary Ann Kleithermas, PharmD, Vice-Chair - Ambulatory Care and Professor at the Chicago College of Pharmacy, Midwestern University, Chicago, Illinois
• Randy McDonough, PharmD, MS, CGP, BCPS, FAPhA, Co-Owner and Director of Clinical Services, Towncrest, Salon Towncrest, and Towncrest Compounding Pharmacies, Iowa City, Iowa
• Eleanor Twigg, PharmD, Clinical and Professional Services Coordinator, Fred's Stores of Tennessee Inc., Memphis, Tennessee