The impact of pharmacist practice of medication therapy management in ambulatory care: an experience from a comprehensive Chinese hospital

Abstract

Backgroud With the reform of medical system in China, Beijing municipal hospitals explored a new pharmaceutical care model and set up medication therapy management services (MTMs) in ambulatory care since 2019. We were one of the first hospitals to set up this service in China. At the present, there were relatively few reports about the effect of MTMs in China. In this study, we summarized the implementation of MTMs in our hospital, explore the feasibility of pharmacist-led MTMs in ambulatory care and the impact of MTMs on patients’ medical costs. Methods A retrospective study was conducted in a university-affiliated, tertiary comprehensive hospital in Beijing, China. The patients who received at least one MTMs and with complete medical records and pharmaceutical documents from May 2019 to February 2020 were included. Pharmacists provided pharmaceutical care for patients according to the MTMs standards issued by the American Pharmacists Association, identified the numbers and classification of the patients’ perceived medication-related demands, identified medication-related problems (MRPs), and developed the medication-related action plans (MAPs). All MRPs found by pharmacists, pharmaceutical interventions, and resolving recommendations were documented, and calculate the cost of treatment drugs that patients can reduce. Results A total of 112 patients received MTMs in ambulatory care, among them 81 cases with the completed record were included in this study. 67.9% of patients had five or more diseases, 83% of them co-took over 5 drugs. While performing MTMs, 128 patients’ perceived medication-related demands were recorded in all, monitoring and judgment of adverse drug reaction (ADR) (17.19%) was the most common demand. 181 MRPs were found, with an average of 2.55 MPRs per patient. Nonadherence (38%), excessive drug treatment (20%), and adverse drug events (17.12%) were the top three MRPs. Pharmaceutical care (29.77%), adjustment of drug treatment plan (29.10%) and referral to the clinical department (23.41%) were the top three MAPs. Whereby the MTMs provided by pharmacists, the cost-saving of each patient was about $ 43.2 monthly. Conclusion By participating in the MTMs of outpatients, the pharmacists could identify more MRPs and develop personalized MAPs timely for patients, thereby promoting rational drug use and reducing medical expenses.

Assessing pharmacogenomic literacy in China through validation of the Chinese version of the Minnesota Assessment of Pharmacogenomic Literacy

“…The increased availability and incorporation of PGx information in MTM enables clinicians to further refine patients' treatment regimens by considering drug‐gene interactions 47 . In China, both MTM and PGx implementation are still in their early stages but experiencing rapid growth 17,48 . The exploration of an integrated model that combines these approaches in a culturally sensitive fashion holds great potential to expedite their development and generate synergistic effects, ultimately leading to more optimized and personalized treatment outcomes for patients.…”

A call to strengthen medication therapy management training in the Kenyan pharmacy undergraduate curriculum: Feedback from a snapshot of the knowledge and practices among pharmacists in diverse disciplines

“…Through appropriate intervention, pharmacists can lessen the burden of complex medication schedules. They can also enhance adherence rates and improve the quality of life for patients while reducing the risk of adverse outcomes and the cost of healthcare (Meng et al, 2023). Therefore, it is crucial to create and implement collaborative models between physicians and pharmacists.…”

“…The second step involves compiling a comprehensive list of prescribed and non-prescribed drugs, dietary supplements, and herbal remedies that the patient may be using (Al-Tameemi & Sarriff, 2019). This enables the establishment of a treatment and monitoring strategy using a personal medication record (PMR) and a medication-related action plan (MAP), the third aspect of MTM (Meng et al, 2023). Intervention, sometimes in combination with referral, comprises the fourth aspect of MTM.…”

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

“…MTM allows pharmacists to engage in the treatment and management of patient cases [10]. As a consequence, they can identify additional DRPs, encourage rational drug usage, and assure medical safety and efficacy, particularly in older adults with comorbidities and multiple medications [3,11,12]. Furthermore, expert prescription recommendations offered by pharmacists will raise patients' understanding of medications, enhance adherence, and lower the financial burden [13][14][15].…”