Certificate Exam
Center for Medicare & Medicaid Services (CMS) provides coverage for people over the
age of 65, blind, or disabled individuals, people with end -stage renal disease
What is CMS and what does it provide?
1st outpatient prescription drug coverage program available to all Medicare
beneficiaries. Private companies approved by Medicare provide the coverage.
What is Medicare Part D?
Medicare Prescription Drug Improvement and Modernization Act: Required Medicare Pt.
D patients with chronic diseases to receive MTM services.
What was the MMA and what did it do?
A system of care that is used to assess patient medications and verify the patient knows
how to use them. In addition, this program attempts to validate all prescriptions with the
patients' conditions and optimize care. This is typically done through collaborative
practice with other healthcare professionals.
What is Medication Therapy Management?
,1. Gather Patient Info (Medical Records, Lab Results, Insurance Companies)
2. Finding issues with patient's medications (Duplicate drugs, Expired prescriptions,
Poor Adherence due to Side Effects or Cost)
3. Determining an Action Plan or MAP
5. Documentation and Follow Up
What are the overall steps of Medication Therapy Management?
- It is PATIENT CENTERED instead of product centered
- a more comprehensive approach focusing on complete health care
- focuses on whole regimen not just one drug
- collaboration of pharmacist and other health care providers
How is MTM different from other pharmacy services?
Outcomes:
- inc. patient understanding
- inc. patient adherence
Goals:
- reduced medication Cost
-reduced preventable adverse events and associated cost
What are the overall goals and outcomes of MTM?
1. Have at least 2 chronic disease states most programs require 3
2. Taking multiple chronic maintenance medications
,3. Likely to incur a high annual medication cost
patients can also elect to have MTM services themselves
How are patients chosen for MTM?
- Heart Failure
-Hypertension (High Blood Pressure)
-Diabetes
-Hiperlipidema (High Cholesterol)
What are some examples of Chronic Health Conditions?
Personal Medication List or Personal Medication Record: goal is to provide user friendly
list of all the patients current medications
What is a Personal Medication List or PMR and what is its job?
dosing, frequency, tips for admin, potential adverse effects, reason for taking
What is some important information to include in the patients PMR?
The Medication Action Plan: identify the goals of MTM service including changes in
medications and other actions to help resolve patients health problems or get to check
points
What is a Therapeutic Action Plan or MAP and what is it's job?
, continuation of care smoothly from one provider to another, so that the patient receives
the most benefit and no interruption in care.
What is "continuity of care"?
No continuity of care is important!
Is MTM a one time process?
The process of comparing what the patient has been prescribed vs. what the patient is
actually taking
What is medication reconciliation?
Transitions of Care (admissions or discharges, switching providers, switching insurance
plans)
What stage of healthcare is the medication reconciliation process usually associated
with?
missing dose/ incorrect dosing
What is the most common error found during medication reconciliation?