What are the best questions to ask patients for effective Medication Therapy Management (MTM) and patient education?

Best Questions for Effective Medication Therapy Management and Patient Education

The most effective Medication Therapy Management (MTM) approach requires a structured assessment that includes comprehensive medication reconciliation, evaluation of adherence barriers, and patient-centered education tailored to individual health goals and preferences. 1

Core MTM Assessment Questions

Medication Reconciliation Questions

• "Are you currently taking or considering taking any supplements, vitamins, minerals, or herbal therapies?" 2
• "Are you seeing or considering seeing any other types of health practitioners for your condition(s)?" 2
• "Can you tell me about how you're using [medication name]? How much are you using? How often do you use it?" 2
• "Have you missed any doses in the past 3 days?" 1
• "What specific challenges do you face taking your medications as prescribed?" 1

Patient Goals and Values Assessment

• "What are the main reasons you are interested in or using these types of therapies?" 2
• "What is an outcome you're hoping to achieve with this medication?" 2
• "How does your condition affect your daily life?" 2
• "How do you feel about your current treatment/this prescription?" 2
• "What matters most to you regarding your health and treatment?" 2

Medication Knowledge Assessment

• "What is your current understanding about [medication name], including possible benefits, risks, and side effects?" 2
• "How has this medication been helping you? Have you experienced any side effects?" 2
• "Do you have any questions or concerns about your medications?" 2

Structured MTM Approach

Step 1: Review and Update Medical Problems

• Include both cardiovascular and non-cardiovascular problems
• Assess for cognitive impairment, fall risk, frailty, and family support 2

Step 2: Medication Reconciliation

• Ask patients to bring all medications or a complete list to visits
• Review prescription medications, over-the-counter medications, and supplements
• Check prescription fill data to assess adherence 2

Step 3: Assess for Medication-Related Problems

• Evaluate drug-drug interactions using electronic health record tools
• Check laboratory data (e.g., eGFR) to determine if dosing adjustments are needed
• Assess for side effects and follow-up testing requirements 2

Step 4: Deprescribing Assessment

• "Are there any medications that don't match up with ongoing medical problems?"
• "Are there duplicate therapies or potentially harmful medications?"
• "Are you struggling with the number of medications you're taking?" 2

Step 5: Patient Education

• Provide written educational materials explaining:
  • Purpose of each medication
  • Administration instructions
  • Common side effects
  • Potential drug interactions
  • When to contact the healthcare provider 1

Patient Education Strategies

Effective Communication Techniques

• Use the "Ask, Tell, Ask" method:
  1. Ask what the patient already knows
  2. Tell them new information
  3. Ask them to repeat back what they understood 2

Written Materials

• Provide a 14-page pre-appointment booklet that encourages logical information sharing and includes sample questions 2
• Ensure written materials are at appropriate health literacy levels 1
• Include a personalized medication action plan 3

Self-Management Support

• Provide a written action plan for conditions like asthma 2
• Teach self-monitoring skills for relevant conditions 2
• Recommend appropriate adherence tools (pill organizers, electronic reminders) 1

Follow-Up and Monitoring

Follow-Up Questions

• "You were going to try [medication/strategy]. What has been your experience?" 2
• "Is the medication meeting your goals?" 2
• "Have you been experiencing any side effects?" 2

Monitoring Plan

• Schedule regular laboratory monitoring for medications requiring it
• Implement therapeutic drug monitoring for narrow therapeutic index drugs
• Screen for high-risk medications that may worsen existing conditions 1

Common Pitfalls to Avoid

• Terminology confusion: Patients often don't understand the term "medication therapy management" - use plain language 4
• Excessive information: Patients may disregard MTM invitations due to information overload from insurance companies 4
• Lack of awareness: Many patients are unaware of their eligibility for MTM services or the pharmacist's role 4
• Inadequate documentation: Failing to document MTM encounters in the patient's electronic medical record 1
• Neglecting transitions of care: Missing medication reconciliation across care transitions 1

By implementing this structured approach to MTM, healthcare providers can optimize medication use, improve adherence, reduce adverse events, and enhance patient outcomes while addressing the challenges of managing multiple medications.