Pharmacists’ Knowledge, Attitude, and Practice of Medication Therapy Management: A Systematic Review

Abstract

Understanding pharmacists’ knowledge, attitudes, and practices (KAP) and their perceptions of challenges, barriers, and facilitators towards medication therapy management (MTM) provision are vital in informing the design and implementation of successful service delivery. Thus, this review examined pharmacists’ knowledge, attitudes, and practices, and their perceived challenges, barriers, and facilitators to MTM services provision, globally. A systematic search was conducted on 1–31 August 2022 to identify relevant studies on PubMed and EBSCO, supplemented with a bibliographic and a particular hand search. We focused on original research in quantitative survey form with the key concepts of “medication therapy management”, “pharmacists”, and “knowledge, attitude, practice”. We assessed the reporting quality using the Checklist for Reporting of Survey Studies (CROSS). Results are reported narratively and according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. From 237 articles identified, 17 studies met the eligibility criteria. Of the included studies, five reported that pharmacists had a considerable level of knowledge, seven suggested a positive attitude among pharmacists, and five revealed that pharmacists had been practicing some MTM elements. Factors associated with pharmacists’ KAP may include age, educational degree, additional qualification, income, years of practice, practice setting, and experience in patient care service. The challenges toward MTM provision were related to the pharmacist-patient and pharmacist-physician relationship. Insufficient time, staff, compensation, and training were the barriers, while patients’ willingness to participate and educational background were the facilitators of MTM provision. These findings of studies on KAP could help develop an MTM program and design an intervention to improve program effectiveness. Further research focusing on other quantitative and qualitative studies of KAP is needed to obtain a comprehensive approach to MTM provision.

Knowledge, attitude, and practice of medication therapy management: a national survey among pharmacists in Indonesia

“…Studies have shown the positive effect of this pilot project of MTM on clinical and humanistic outcomes ( 6 – 8 ). These findings are consistent with those of many studies that have demonstrated the benefits of MTM on clinical, economic, and humanistic outcomes in other countries ( 5 , 10 ).…”

“…Generally, the health facility/organization factor became the main barrier for pharmacists. Pharmacists in the studies in other countries perceived similar barriers to MTM, including the lack of time, staffing, compensation, and training ( 10 ). Fewer identified facilitators indicated that pharmacists appeared to emphasize barriers and overlook facilitators.…”

“…Similarly, experience in providing MTM services becomes a factor associated with pharmacists’ KAP. A systematic review suggests that factors increasing direct involvement in patient-oriented or MTM services can improve the understanding of MTM ( 10 ).…”

“…Pharmacists’ competency, which includes knowledge, attitude, and practice (KAP), contributes to MTM success ( 11 , 12 ). Therefore, the assessment of KAP regarding MTM is essential to the strategic plan for effective program implementation ( 10 ). To the best of our knowledge, studies on the KAP toward MTM and its factors in Indonesia are limited.…”

Exploring knowledge, attitudes and practice toward medication therapy management services among pharmacists in Yemen

“…Similar medication management strategies have also been adopted in other nations, including the UK's Medication Use Review (MUR), Australia's Quality Use of Medicine (QUM), and Residential Medication Management Review (RMMR) [16,17]. However, the USA MTM approach has been accepted for use in many nations [18,17]. According to a 2004 survey conducted in the United States, just about 17% of pharmacies provided disease-state management services, and only 10% of pharmacists provided MTM services [19].…”