When it comes to the explanation of the services pharmacists provide, a guidebook of acronyms needs to be provided to all those involved in these discussions. CDTM (collaborative drug therapy management), MTM (medication therapy management), and CPA (collaborative practice agreements) are the most commonly used and all three of these will be addressed in this blog.
The term Collaborative Drug Therapy Management was used as early as the 1960’s by the Indian Health Service. Since that time numerous articles have been published describing in great detail what CDTM is. In 1999, 10 national pharmacy organizations joined forces to form the Alliance for Pharmaceutical Care and defined CDTM as follows:
Collaborative drug therapy management (CDTM) is a team approach to healthcare delivery whereby a pharmacist and prescriber establish written guidelines or protocols authorizing the pharmacist to initiate, modify or continue drug therapy for a specific patient.
The term MTM was adopted by the Centers for Medicare & Medicaid Services (CMS) and incorporated into the 2003 Medicare Part D legislation. A consensus definition of MTM was developed and endorsed by national pharmacy organizations in 2004 and is as follows:
Medication therapy management (MTM) is medical care provided by pharmacists whose aim is to optimize drug therapy and improve therapeutic outcomes for patients.
The term Collaborative Practice Agreements (CPA) was adopted by a roundtable consortium convened by the APhA Foundation in 2012. The purpose of this group of 22 national subject matter experts was to identify evidence for effective policies, practices, and key supports and barriers to expanding the role of pharmacists in delivering patient care services and entering into CPAs. Their definition of CPA is follows:
Pharmacist Collaborative Practice Agreement (CPA) is a formal agreement in which a licensed provider makes a diagnosis, supervises patient care, and refers patients to a pharmacist under a protocol that allows the pharmacist to perform specific patient care functions.
The consortium also updated the definitions of CDTM and MTM:
Collaborative Drug Therapy Management (CDTM): A collaborative practice agreement between one or more providers and pharmacists in which qualified pharmacists working within the context of a defined protocol are permitted to assume professional responsibility for performing patient assessments, counseling, and referrals; ordering laboratory tests; administering drugs; and selecting, initiating, monitoring, continuing, and adjusting drug regimens.
Medication Therapy Management (MTM): A distinct service or group of services that optimizes therapeutic outcomes for individual patients. MTM includes five core elements: medication therapy review, personal medication record, medication-related action plan, intervention and/or referral, and documentation and follow-up.
An excellent document “Collaborative Practice Agreements and Pharmacists’ Patient Care Services A Resource for Pharmacists” is a compilation of the consortium’s proposed strategies and case studies. To download this pdf document, click here
This document is a wonderful tool to help pharmacists educate other health care providers, legislators, insurers, and the general public about the value of pharmacists and the services they provide through CDTM, MTM and CPA.