MEDICATION therapy management (MTM) is a service offered by clinical pharmacists that enhances patient care through a focus on their medications.

Clinical pharmacists are medication experts and are highly trained in medication management to optimise patient health outcomes.

Partners Interventional Centre of Jamaica (PICJ’s) resident clinical pharmacist Dr Melecia Pinnock shares her insight on adding MTM to your health-care plan.

The best care is integrated care. For people with chronic illnesses especially, this looks like working closely with your cardiologist or other specialists, family doctor, dietitian and your clinical pharmacist. The clinical pharmacist acts as liaison between all your health-care providers. They will look at all the medications a patient is prescribed, as well as evaluate diet and lifestyle because, according to Dr Pinnock, all these things will impact how the body responds to the medication.

“We also look at how well the combination of medication works for you and if there is room for optimising the therapy, meaning choosing more appropriate treatments for you,” Dr Pinnock says.

As experts in the chemical properties of medications, clinical pharmacists focus on how the drug interacts with your body processes and decipher the benefit you get from the consumption of these items. “It’s an intricate area where you focus on outcomes based on the introduction of medicines.”

Dr Pinnock recognised a gap in patient care as it related to prescription medications. “A patient will be prescribed numerous medications without [doctors] looking at how well these drugs interact, or if the drug is causing undesired outcomes, and as a result we see patients repeatedly coming to hospital with adverse drug reactions,” she says. “I recognized through my training we could really plug that gap. Collaborative, integrated care is the best care a patient can receive.”

Once you’re taking medication you are eligible to visit a clinical pharmacist. Particularly, if you have chronic diseases, Dr Pinnock recommends being enrolled in an MTM programme.

“As we age, our body processes and functions change, and how we respond today is not how we respond tomorrow,” she says. “Sometimes we’re on long-term treatments and we’re not certain if there are any developments in the patient’s care journey.” The clinical pharmacist would pick up on these inadequacies and augment a care plan specific to the patient’s needs.

Heart patients are often polymedicated (taking multiple medications) and see multiple doctors. The clinical pharmacist is the connection point for all health-care providers and can assess the care plan and medication to maximise the benefits to the patient. They can advocate for the patient to have medications changed, and can compare any new medications before patients commence taking them, to see if there could be disruptions with existing ones.

Even with insurance, accessing medications can sometimes be costly. A clinical pharmacist can reconcile medications and recommend more affordable options for patients. Dr Pinnock notes that MTM is covered under Sagicor insurance.

For Dr Pinnock, the aim of the clinical pharmacist is to increase the patient’s quality of life. Sometimes slight adjustments make a difference. “For example, long-term use of certain heart medications depletes our natural store of vitamins, and a clinical pharmacist can assess and recommend the right supplements or dietary adjustments,” Dr Pinnock says.

We know there is a culture of relying on holistic medication for treating many ailments, even chronic illness, in Jamaica. For a patient who combines conventional medicine with alternative medicines such as herbs and oils, a clinical pharmacist should definitely be added to their care team to monitor their progress. Alternative remedies sometimes mask warning signs, landing patients who are asymptomatic in the emergency room. The clinical pharmacist is equipped to pinpoint the counteraction and can better coach the patient through medication management.

“The issue with natural remedies is we don’t always know the concentration of the active agents in them,” Dr Pinnock says. “This can lead to inconsistent care where the remedy is sub-therapeutic or not enough, or toxicity where it is too much.” The clinical pharmacist could also be first in line to recommend screenings and testing to ensure a patient’s positive feeling after using natural remedies is not just a placebo.

The most important thing for patients, especially those with chronic illnesses, is support, and that is the foundation of medication therapy management. And this support is continuous, as the health-care journey of patients can be tracked through PICJ’s patient mobile application.

Working closely with medical doctors to come up with ideal treatment for their patients is Dr Pinnock’s overall goal.

“If people are serious about improving their quality of life, quantity of life, saving money, and reducing distress from complex therapy, then MTM is really the solution for them.”

Partners Interventional Centre of Jamaica is a full-service heart centre located on the second floor of the Medical Associates Hospital. For appointments, email info@pic-jm.com or call /WhatsApp 876 9957425.