How Pharmacist Practice Affects Medication Therapy Management

Clinical pharmacists play an important role in optimizing medication outcomes. One area where this is especially important is during care transitions. Medication therapy management (MTM), a collection of services that maximizes therapeutic results for specific patients, is concerned with the usefulness, efficacy, safety, and adherence of medications to enhance patient treatment outcomes. MTM allows pharmacists to use their skills and experience to resolve possible drug-related problems. It’s important to identify the obstacles facing MTM services in pharmacy practice.


Healthcare costs are a primary focus for many stakeholders, from patients to regulators and politicians. In response to this concern, many forward-thinking hospitals are turning to pharmacists to reduce their cost per patient. The pharmacists’ role is changing from drug distribution and supply to a critical part of the interprofessional health care team that improves clinical outcomes and reduces costs. Pharmacists can help lower the cost of healthcare by enhancing adherence and reducing the incidence of adverse events. 

Additionally, pharmacists can provide a range of health, wellness, and public health services. These services can include screening programs for common disease states, nutritional planning, smoking cessation counseling, and other preventive measures. Many studies have shown that pharmacists reduce costs in various settings. However, there need to be more high-quality economic evaluations demonstrating the specific aspects of pharmacist services and interventions that are most effective in lowering costs. Future, high-quality economic evaluations that use robust methodologies and study design are needed to identify what pharmacist services have the greatest impact on healthcare savings. Medication therapy management services can lower healthcare costs by addressing medication-related problems such as uncontrolled hypertension, cardiovascular disease and stroke risk factor. It can be achieved through comprehensive MTM clinics, including physician and patient interaction, medication education, and one-to-one patient teaching with low-literacy techniques.

Medication Errors

Pharmacy errors can be costly to both the health system and patients. Often these mistakes are preventable and can be detected before they cause harm. For example, illegible handwritten prescriptions or drugs with similar names can confuse. Errors can also occur due to poor documentation, including a lack of drug samples and medication history monitoring. Pharmacy error prevention programs include reporting systems, pharmacist training, and other measures. Medication errors can be prevented by implementing new technologies that improve patient safety and the quality of care. These technologies can help identify risks, alert patients, and track adherence. They can also help reduce hospital readmissions. Many of these initiatives require collaboration between multiple healthcare organizations and other professionals. Many respondents say that payers need to see the value of these services. They can then develop a more holistic approach to improving health and wellness and reducing costs.

The most effective way to reduce medication errors is to build trusting relationships with patients. Pharmacists should ask questions and encourage patients to participate in their health actively. They should also call the prescriber if they notice an unusual side effect or other questionable issue. They should also use a basket system to separate medications and avoid distractions when answering phone calls. The five rights should continue to be the core of a medication-use policy, and strong support systems should be in place to promote safe practices.


A major challenge in the healthcare industry is medication non-adherence. Non-adherence can result in health decline and prevent the achievement of goals that patients may have set with their physician. Non-adherence can also cause financial challenges for patients and payers. Some reasons for non-adherence include poor health literacy, forgetfulness, and difficulty finding time to visit a doctor or pharmacy. These problems can be overcome by pharmacists, who can help educate patients, encourage adherence, and provide reminders for pill-taking or annual wellness visits.

Pharmacists who collaborate with ambulatory care teams in health systems may offer a vital service to raise the standard of patient care and guarantee compliance. Continuity of relationships can be important for patients; some participants indicated that patients who always see the same pharmacist experience better results than those who have different pharmacists each time.

Preventable Hospitalizations

The cost of hospitalizations is a significant component of the United States healthcare expenditures. Potentially preventable hospitalizations are inpatient stays for treating ambulatory care-sensitive conditions that evidence suggests could have been avoided through access to high-quality primary and preventive healthcare services. It includes visits for urinary infections, bacterial pneumonia, dehydration, diabetes, hypertension, chronic obstructive pulmonary disease, asthma, and other illnesses. Pharmacists can help reduce these potentially avoidable hospitalizations by leveraging their expertise in chronic condition management, prevention and wellness, diagnosing and treating minor acute illnesses, supporting mental health, and helping patients age in place. They can also support patients who use multiple medications, such as seniors, by assisting them to manage these drugs safely and effectively.

Providing pharmacists with the necessary skills to perform these advanced direct patient-care tasks requires significant changes in education and practice. For example, the traditional model of pharmacy professional development is shifting from continuing education to competency-based training that focuses on outcomes and practical applications. Productivity metrics that value the speed at which prescriptions are dispensed may encourage pharmacists to pursue these more hands-on clinical activities. Credentialing and privileging can help overcome these barriers by allowing pharmacists to work under the supervision of a licensed physician.