Pharmacist (MTM Clinic)

MAIN FUNCTION:

Medication Therapy Management Services

• Conduct comprehensive medication reviews (CMRs) and targeted medication reviews (TMRs)

• Assess medication regimens for:

• Appropriate medication selection

• Appropriate dose

• Appropriate route

• Appropriate frequency

• Appropriate indication

• Therapeutic effectiveness

• Safety concerns

• Patient adherence and barriers

• Identify, prevent, and resolve medication-related problems

• Develop individualized medication action plans

• Communicate recommendations to providers and healthcare teams

• Follow up on medication changes and clinical outcomes

Clinical Pharmacist Assessment

Evaluate patient-specific factors including:

• Drug-drug interactions

• Drug-disease interactions

• Allergies and intolerances

• Renal function considerations

• Hepatic function considerations

• Laboratory monitoring needs

• Contraindications and precautions

• Duplicate therapy

• Medication affordability and access barriers

Patient Care & Education

• Provide medication counseling and education to patients and caregivers

• Promote medication adherence and self-management strategies

• Educate patients regarding:

• Medication purpose

• Expected benefits

• Potential adverse effects

• Monitoring requirements

• Lifestyle modifications

• Support patients in understanding and managing chronic conditions

Chronic Disease Management Support

Provide pharmacist-led interventions and monitoring for conditions such as:

• Diabetes

• Hypertension

• Hyperlipidemia

• Anticoagulation therapy

• Asthma/COPD

• Heart failure

• Other chronic disease states as identified by clinic needs