Table 4 Components of comprehensive pMTM Intervention
Major Activity | Specific Components | Duration |
|---|---|---|
Comprehensive review of medication regimen | 1. Update medication list | 10–15 min |
2. Review patient/caregiver goals for each therapy | ||
3. Confirm adherence or identify barriers to adherence (e.g., cost, taste aversion, difficult administration) | ||
4. Review current effectiveness for any targeted symptoms or lab values | ||
5. Identify therapeutic duplication and/or potentially unnecessary therapies | ||
6. Review for potentially medication-attributable symptoms or adverse effects | ||
Optimization of medication regimen | 1. With caregiver, identify list of ongoing concerns – could be ADEs, symptoms perceived to be undertreated, less-than-ideal administration schedule. Prioritize this list according to (1) safety, (2) patient quality of life, (3) caregiver/family quality of life | 10–15 min |
2. Formulate plan for medication adjustment (e.g., dose optimization, schedule change, formulation change), discontinuation, or initiation to address above issues. May be list of medication changes today or a detailed plan for recommendations to take back to a subspecialist | ||
3. Include expectations for both subjective monitoring and objective labs or tests (e.g., ECG) that will be necessary/recommended, with expected timeline | ||
Creation of medication action plan | 1. Caregiver-friendly medication list (directly populated from EHR) | 5–10 min |
2. Bulleted list of current changes (to make today) and planned changes | ||
3. Plan for follow-up with pharmacist or another provider |