MISSISSIPPI DELTA – In a region of America where money for healthcare is tight and diseases such as diabetes and hypertension are as common as cotton fields in the summer, patients here always ask the same two questions:

“Am I getting the right medicine to make me feel better?”
“Can I afford the medicine I need?”

A new program launched by the Delta Health Alliance and the School of Pharmacy at the University of Mississippi is working to make sure the answer to both questions is always “yes.”

“As pharmacists, we want to get out from behind the counter and become more involved in patient care,” said Tommy Spell, coordinator of community development at the School of Pharmacy. “The opportunity is certainly there.”

Known as Medication Therapy Management (MTM), this new effort is a partnership between pharmacists and patients that promotes the safe and effective use of medications, and helps patients achieve targeted outcomes at the lowest costs possible. Begun in July 2008, the program focuses on two areas:

• Generalized MTM in which the pharmacist partners with patients to conduct a complete review of all medications, ensures that diseases are addressed by medications with no adverse reactions, and that patients are taking their medications.
• Specialized MTM, in which faculty from the School of Pharmacy focus on specific diseases such as asthma and diabetes and provide direct patient care in Delta pharmacies. Recommendations are then made to the patients’ physicians.

Once both programs are in full swing, the goal is to assist 2,500 patients. To be part of the Generalized MTM program, pharmacists must commit to at least half a day each week to meet with patients.

“We’re trying to address the health provider shortage in an area that has the largest need and the least resources,” said Leigh Ann Ross, associate dean for clinical affairs at the School of Pharmacy. “Many patients see their pharmacy as a source of health education. So there is a brick and mortar place to be in every community already.”

Funding from the Delta Health Alliance goes to support faculty and staff at the pharmacy school and participating local pharmacists. It also pays for supplies, tests, screenings and demonstrations. It’s a team approach that allows pharmacists to participate in the development of the physician’s plan for the patient.

“We as pharmacists still take care of patients at the local level,” said Spell. “We want to make sure they have the right drugs. We want to find opportunities to save the patients money by ensuring they have the lowest cost drugs, and we want to avoid duplication of therapy.”

Patient education, community outreach, and removing the barriers that prevent low-income patients from affording needed medicine are the keys to the success of the program, said Spell.

Another key, and second major goal of the program, is to incorporate the use of Electronic Health Records (EHR).

Physicians such as Greenville cardiologist Kenneth Hahn, who are already utilizing EHR through another program funded by the Delta Health Alliance, would be able to electronically share part of the patient’s medical chart with the pharmacist. Having access to those records, with the patient’s consent, would help pharmacists better work with patients to prevent dangerous drug interactions, and provide sound advice with the confidence that comes from being fully informed on the patient’s medical history. The result is that the expertise of the pharmacist would become an integral part of the total package of care provided to the patient.

The bottom line when it comes to Medication Therapy Management, said Spell, is to “target pharmacists who have a real desire to be part of the project and to make sure the model is a success.“This is a team effort,” he said. “And it’s the patient who always comes first.”