Abstract
Ongoing healthcare reform calls for increased accessibility, enhanced delivery, and improved quality of healthcare. Children and adolescents are experiencing a rise in the prevalence in chronic diseases leading to an increased utilization of medications. The increased use of chronic medications can lead to more medication errors or adverse drug events, particularly in children and adolescents using multiple chronic medications. These ongoing changes expand opportunities for a pharmacist to become further integrated in the inter-professional healthcare delivery for pediatric patients, particularly in an ambulatory or community setting. To date, a systemic process for the provision of medication therapy management (MTM) services in pediatric patients has not been elucidated. The purpose of this paper is to describe a proposed model for delivering pediatric MTM. Furthermore, based on the available literature related to pediatric patients at risk for medication errors, adverse drug reactions, and subsequently-increased utilization of emergency departments and hospitalizations, a set of criteria is proposed for further research investigation.
Highlights
Larkin Health Sciences Institute, College of Pharmacy, 18301 N
Medication therapy management (MTM) is known to other healthcare providers and is an established model with specific requirements in adults defined by the Centers for Medicare and Medicaid Services (CMS)
Pediatric patients with a complex chronic disease have an increased risk for an adverse drug events (ADEs) related emergency department visit compared to those without a complex chronic disease
Summary
Medication therapy management became a required benefit for all Medicare Part D beneficiaries through the enactment of the Medicare Modernization Act of 2003 (MMA) [5]. The intention of MTM is to improve medication use by optimization of therapeutic outcomes and reducing adverse drug events (ADEs) in high risk patients. In the Medicare population, eligibility for MTM requires (at a minimum) that beneficiaries meet the following criteria: (1) the presence of multiple chronic diseases;. (2) take multiple prescription medications; and (3) incur a specified dollar amount for covered Part. Since pediatric patients are not beneficiaries of Medicare, implementation of MTM for this population has been limited [6,7]
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