1. MTR - medication therapy review

2. PMR - personal medication record

3. MAP - medication-related action plan

4. Intervention and/or referral

5. Documentation and follow-up

1. Comprehensive - prescriptions, OTCs, herbals, dietary supplements

2. Targeted - ideally performed for pt who have already had a comprehensive MTR; Assesses a problem specifically in the context of the complete medication history

1. Clinical appropriateness of each med (benefit vs risk)

2. Appropriateness of dose and dosing regimen (Ind, CI, ADE, ddi)

3. Therapeutic duplications or unnecessary meds

4. Adherence

5. Untreated diseases or conditions

6. Medication cost cosiderations

7. Healthcare/medication access considerations

What are some things that may be included on a PMR?

1. Name
2. DOB
3. Phone number
4. emergency contact info
5. primary care physician
6. pharmacist
7. allergies
8. other medication-related problems
9. potential questions for pt to ask about their meds
10. date last updated
11. date last reviewed by pharmd, md, or other
12. pt's signature
13. health care provider's signature
14. medication info

1. medication name and dose

2. indication

3. instructions for use

4. start date

5. stop date

6. ordering prescriber/contact info

7. special instructions

1. Name
2. PCP
3. Pharmacy/pharmacist
4. Date of MAP creation
5. Action steps "What I need to do..."
6. Notes for the pt "What I did and when I did it..."
7. Appointment information for follow-up with pharmacist, if applicable

Which core componenet of MTM does the following describe:

The pharmacist provides consultative services and intervenes to address medication-related problems; when necessary, the pharmacist refers the patient to a physician or other healthcare professional.