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