Abt Associates, Inc., Cambridge, MA 02138, USA.
J Am Pharm Assoc (2003). 2011 Jul-Aug;51(4):520-6. doi: 10.1331/JAPhA.2011.10210.
To describe the features of medication therapy management (MTM) programs, including eligibility criteria, enrollment, services, and reimbursement, and to describe the criteria used to evaluate MTM programs and assess the evidence of relevance to Medicare.
Descriptive, exploratory, nonexperimental study.
United States between July 2007 and June 2008.
60 key informants from 46 different organizations and case studies with 28 representatives from four MTM programs.
Literature review, key informant interviews, and evaluation of case studies.
MTM program features and evidence of effectiveness.
MTM programs used a variety of practice models. Medicare MTM programs used different eligibility criteria than MTM programs sponsored by Medicaid or other payers. MTM programs that required patients to opt-in had less success in enrolling participants than those using opt-out. Most MTM programs conducted annual medication reviews. Most non-Medicare MTM programs provided face-to-face interventions, whereas Medicare MTM programs relied more on telephone or mail; no research tested the effectiveness of different modes. Almost all MTM programs used pharmacists to provide services. Little research on Medicare MTM programs was available. Costs were commonly measured in the MTM literature, although results were inconsistent. A few studies demonstrated significant improvements in intermediate outcomes (e.g., low-density lipoprotein cholesterol), while less studies demonstrated an impact on serious sequelae (e.g., emergency department visits).
Medicare MTM programs were still evolving when this study was conducted, and we found limited evidence to determine which beneficiaries would benefit most from MTM, which features achieved the desired outcomes, and which outcomes should be measured to compare MTM program performance.
描述药物治疗管理 (MTM) 计划的特点，包括资格标准、注册、服务和报销，并描述用于评估 MTM 计划的标准以及评估与医疗保险相关的证据。
描述性、探索性、非实验性研究。
2007 年 7 月至 2008 年 6 月期间的美国。
来自 46 个不同组织的 60 名关键信息提供者和 28 名来自四个 MTM 计划的案例研究代表。
文献回顾、关键信息提供者访谈和案例研究评估。
MTM 计划的特点和有效性证据。
MTM 计划采用了多种实践模式。医疗保险 MTM 计划使用的资格标准与由医疗补助或其他支付者赞助的 MTM 计划不同。要求患者选择加入的 MTM 计划在注册参与者方面不如使用选择退出的计划成功。大多数 MTM 计划进行年度药物审查。大多数非医疗保险 MTM 计划提供面对面干预，而医疗保险 MTM 计划更多地依赖电话或邮件；没有研究测试不同模式的有效性。几乎所有 MTM 计划都使用药剂师提供服务。医疗保险 MTM 计划的研究很少。在 MTM 文献中经常衡量成本，尽管结果不一致。一些研究表明中间结果（例如，低密度脂蛋白胆固醇）有显著改善，而较少的研究表明对严重后果（例如，急诊就诊）有影响。
当进行这项研究时，医疗保险 MTM 计划仍在不断发展，我们发现有限的证据来确定哪些受益人最受益于 MTM、哪些特点实现了预期的结果，以及应该衡量哪些结果来比较 MTM 计划的绩效。
