Medication therapy problem documentation and reporting: A review of the literature and recommendations

Abstract

Pharmacists are increasingly using medication therapy problem (MTP) metrics to monitor their clinical impact and demonstrate their value to health care organizations and commercial payers. Although the practice of documenting and resolving MTPs is well reported in the literature, there remains great diversity in how MTPs are categorized, documented, and reported. We conducted a review of the literature to gain key insights into the MTP classification systems, methods of MTP documentation, and MTP-related outcomes that are reported in the literature, as well as the elements of MTP documentation that are commonly employed in practice. Ninety-one articles were identified. These insights were used to develop a set of recommendations to help standardize the practice of MTP documentation in the profession. This review highlights the findings from these studies and outlines a set of recommendations for identifying, categorizing, documenting, and monitoring MTPs that can be applied across care settings. The recommendations include clearly defining the purpose for documenting MTPs; using an established, standardized MTP categorization framework and applying that framework consistently in practice; establishing a clear process for identifying and resolving MTPs; systematizing the documentation and reporting process; tracking the resolution of MTPs identified; and monitoring MTP data and assessing impact. MTP identification, documentation, and reporting are an important strategy for capturing, monitoring, and sharing the unique contributions of pharmacists in providing patient care. Although additional research is needed to clearly demonstrate the relationship between MTPs and humanistic, clinical, and economic outcomes, MTP resolution may be a useful process metric to demonstrate the value-added role of the pharmacist in the delivery of team-based, patient-centered care.clinical pharmacy services, drug, health care, medication therapy management, outcome and process assessment | INTRODUCTIONThe primary goal of health care is to improve the health and wellbeing of patients. Medications play a significant role in the prevention and treatment of short-term and long-term therapy disease, and pharmacists are uniquely poised as highly educated and trained medication specialists to optimize medication use and improve the health of patients. 1 Through the provision of comprehensive medication management (CMM), pharmacists helps ensure patients' medications are appropriate, effective, and safe, and that patients are adhering to

Comprehensive medication management services provided via telehealth or hybrid models: A scoping review

“…These resolution rates are comparable with the literature on MRPs resolved with traditional in‐person CMM, which typically ranged from 49% to 100% 37,38,39 . The heterogeneity in MRP reporting and resolution highlights the importance of specificity and standardization to compare intervention strength 40,41 . Importantly, one study found significantly fewer identified and resolved MRPs in telehealth versus face‐to‐face contact 33 .…”

“…37,38,39 The heterogeneity in MRP reporting and resolution highlights the importance of specificity and standardization to compare intervention strength. 40,41 Importantly, one study found significantly fewer identified and resolved MRPs in telehealth versus face-to-face contact. 33 The authors hypothesized the difference to be the inability to obtain remote patient monitoring data, time and resource constraints, and gaps in patient digital literacy.…”

Medication-Related Problems and Interventions Identified and Addressed by Pharmacists Conducting Enhanced Medication Therapy Management Services

“…A focus on upgrading documentation systems or rearranging workflow may be needed to replicate results. Using a standardized method of documenting MRPs may allow for multiple pharmacies’ data to be analyzed and provide insight into the pharmacist’s role in patient care [ 30 ]. Research should also continue to explore the prescriber acceptance rates and the factors that impact the acceptance rates.…”

Medication therapy problems assessment within medication history objective structured clinical examinations using standardized patients versus peer actors

“…Throughout their didactic and experiential training, pharmacy students are expected to identify and resolve medication therapy problems (MTPs) 16 . MTPs are events involving pharmacotherapy requiring pharmacist interventions to improve patient outcomes 17,18 . The Pharmacy Quality Alliance (PQA) MTP Categories Framework is the most recognized system to categorize MTPs in clinical practice and to teach the Pharmacist Patient Care Process 17,19,20 .…”

“…MTPs are events involving pharmacotherapy requiring pharmacist interventions to improve patient outcomes 17,18 . The Pharmacy Quality Alliance (PQA) MTP Categories Framework is the most recognized system to categorize MTPs in clinical practice and to teach the Pharmacist Patient Care Process 17,19,20 . Conway et al and Douglass and Ahmed reported on MTPs in disease management and capstone courses but neither utilized SPs 21,22 …”