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How to conduct Comprehensive Medication Reviews

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Integrate Comprehensive Medication Reviews (CMRs) into your pharmacy workflow

In brief:

  • Medication therapy management (MTM) interventions help to provide quality patient care.
  • While beneficial, many patients don’t receive a Comprehensive Medication Review (CMR). Pharmacies should consider taking advantage of this patient interaction opportunity.
  • Integrating MTM services into the pharmacy workflow improves operations.

3 types of medication therapy management

The three types of medication therapy management (MTM) services are shown below.

Type of MTM

What it is

Duration

Unique elements

Targeted interventions In-person or phone consultations between pharmacists and patients focused on adherence for a condition or a single medication 5 to 15 minutes Addresses topics like barriers to adherence, proper usage, side effects or gaps in care
Comprehensive Medication Reviews (CMRs) Comprehensive in-person consultations where pharmacists collect patients’ clinical information and medication history, assess prescription and over-the-counter (OTC) medication usage, identify potential medication problems, and create plans to solve problems. Patients receive medication action plans and physician prescribers receive documentation. 45 to 60 minutes Completed annually; is a Star Rating measure on which pharmacies are evaluated
Targeted Medication Reviews (TMRs) Follow-up consultations between pharmacies and patients after a Comprehensive Medication Review (CMR) 15 minutes or less Typically done quarterly

Medicare allows each beneficiary to receive one comprehensive medication review (CMR) per year. Currently fewer than half of eligible patients receive an annual CMR.

5 core elements of MTMs

  • Medication therapy review (MTR)
  • Personal medication record (PMR)
  • Medication-related action plan (MAP)
  • Intervention and/or referral
  • Documentation and follow-up

Customize the sequence and delivery to meet your patients’ needs.

Focusing on pharmacy workflow

By performing CMRs, pharmacies can improve their Star Ratings, provide better patient care and increase reimbursement revenue.

Don’t let time become an obstacle. To improve time management and workflow, focus on technology and staffing and adopt best practices listed in this article.

Technology

One way to minimize CMR operational costs is to use technology.

  • Integrate. Use technology to integrate services into the pharmacy’s daily workflow. When available, take advantage of integration of MTM portals into your pharmacy management system and into your pharmacy’s daily workflow to check and work available cases.
  • Synchronize. To maximize the efficiency and effectiveness of interventions, synchronize MTM services with the patient’s monthly prescription pickup or other clinical services.

Staffing 

As part of the workflow, creating and implementing disciplined staff processes frees up time for more CMRs.

  • Educate staff. Educate staff on the objective and processes surrounding MTMs. Make sure staff members understand their roles and responsibilities.
  • Check the portals. Make it part of technicians’ regular schedules to check portals for MTM opportunities, including CMRs. Many plans update potential cases quarterly, but more than 25% do it monthly, and some more frequently. Catch cases before they expire.
  • Make patient acceptance easy. When talking with patients, explain the benefits, and let them know if their insurance covers CMRs.
  • Gather data. Assign staff to gather medication information and relevant lab results or at-home monitoring information. If patients receive prescriptions from other pharmacies, request they bring in the containers to verify information such as dosage. Include the patient’s history data on OTC products and any additional information on diet and exercise to better build the patient’s profile. Train technicians and interns to flag potential issues for the pharmacist.
  • Prepare. Prior to the CMR, provide the pharmacist with a form that contains information the technician has gathered. Block off time for the pharmacist to review this information beforehand.
  • Manage time wisely.
    • Dedicate and block off set days and times for CMRs
    • Follow an established agenda
    • Use simple, concise and easy-to-complete forms
    • Follow an established protocol for informing prescribers of issues and plans
    • Delegate to technicians or interns completion of documentation and submitting comprehensive medication review sessions for payment

The bottom line: MTMs and CMRs can improve your pharmacy’s performance, increase revenue and build long-term relationships with patients. Pharmacy technology and disciplined staffing processes offer solutions to potential roadblocks.

For more information, download the free Health Mart guide, “Medication Therapy Management 101.”

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