What are the most pertinent questions to ask a patient during a pharmacy Medication Therapy Management (MTM) session?

Most Pertinent Questions to Ask During Pharmacy MTM Sessions

The most important questions during a Medication Therapy Management (MTM) session should focus on medication reconciliation, adherence assessment, and identifying drug-related problems to optimize patient outcomes and reduce mortality and morbidity risks.

Medication History and Reconciliation

• Ask patients to bring all medications or a complete list to visits, including:

  • All prescription medications
  • Over-the-counter medications
  • Dietary or herbal supplements 1
  • Traditional and complementary medicines 2

• Verify medication details:

  • "What is the name, strength, and dosing schedule for each medication?"
  • "When did you start taking each medication?" 2
  • "Have there been any recent changes to your medications?" 1
  • "Are you using multiple prescribers or pharmacies?" 2

Medication Understanding and Administration

• Assess patient knowledge:

  • "What do you understand about why you're taking each medication?" 1
  • "How do you take your medication? (with/without food, whole/crushed, timing)" 2
  • "Do you use any tools to help remember your medications (pill caddies, calendars)?" 2

• Administration challenges:

  • "Do you have any difficulty swallowing pills or using your medications?"
  • "Do you understand how to use your devices/inhalers/injections correctly?"
  • "Do you know how to store your medications properly?" 1

Medication Adherence

• Direct adherence questions:

  • "Have you missed any doses in the past week?" 1
  • "What specific challenges do you face taking your medications as prescribed?" 1
  • "Do you ever skip doses intentionally? If so, why?" 2

• Financial concerns:

  • "Are you having any difficulty affording your medications?" 2
  • "Are you aware of assistance programs that might help with medication costs?" 2

Side Effects and Concerns

• Medication experience:

  • "Have you experienced any side effects from your medications?" 1
  • "Are there any medications that you're particularly concerned about?" 1
  • "Have you noticed any new symptoms since starting any medications?" 2

• Efficacy assessment:

  • "Do you feel your medications are working for you?" 1
  • "Are your symptoms well-controlled with your current medications?" 1

Lifestyle and Health Behaviors

• Daily habits:

  • "What is your typical daily routine, and how do your medications fit into it?" 1
  • "Do you use tobacco, alcohol, or recreational drugs?" 2
  • "What is your diet like? Do you follow any specific dietary patterns?" 2

• Health monitoring:

  • "Do you monitor any health parameters at home (blood pressure, blood sugar)?" 1
  • "When was your last laboratory test for medication monitoring?" 1

Social and Environmental Factors

• Support system:

  • "Who helps you manage your medications, if anyone?" 2
  • "Do you have reliable transportation to pick up your medications?" 1
  • "Where do you store your medications at home?" 2

• Living situation:

  • "Have there been any recent changes in your living situation that affect how you take your medications?" 2
  • "Do you have any concerns about medication safety in your home?" 2

Special Population Considerations

For Older Adults

• "Do you have any difficulty opening medication containers?" 2
• "Have you experienced any falls recently?" 2
• "Do you have any memory concerns that affect taking your medications?" 2

For Patients with Multiple Chronic Conditions

• "Which health condition concerns you the most?" 1
• "What matters most to you regarding your health and treatment?" 1

Common Pitfalls to Avoid

1. Failing to verify all current medications - Always use at least two patient identifiers (name, date of birth) when reviewing medications 2

2. Missing potential drug interactions - Actively review drug interactions at each encounter by asking about all medications including OTC and supplements 2

3. Not addressing adherence barriers - Explore specific reasons for non-adherence rather than just asking if patients take their medications 1

4. Overlooking patient priorities - Ask what matters most to patients regarding their health and treatment 1

5. Using medical jargon - Use plain language when discussing medications and health conditions to ensure patient understanding 3

By systematically addressing these key areas during MTM sessions, pharmacists can effectively identify and resolve medication-related problems, improve adherence, and ultimately enhance patient outcomes.