Earlier this year I had the privilege of attending the presentation, "Engaging the Older Patient in Medication Management" given by Linda M. Strand, pharmacist and professor.  Linda's presentation turned my preconceived notion of the "medication management" problem upside down and on its head.  I truly believed it had to due with lack of adherence.  Not so! Linda told us that 80% of drug therapy problems were NOT due to drug adherence. But, there is good news.  There is a service (reimbursable by Medicare D) that can help enormously...Medication Therapy Management (MTM). However, the public and healthcare/eldercare professionals need to know it exists.

Linda told us that 1/3 Americans take more than 5 medications.  Also, older adults often have multiple physicians and may go to multiple pharmacies.  Without a service like MTM, there is no comprehensive oversight to manage a person's medications.  Consider the consequences of this lack of management:  the possibility of drug interactions, ineffective drugs (due to low dosage...), the patient's lack of knowledge of how to take the drugs or inability to take the drugs.  

In Medication Therapy Management, MTM, a pharmacist works together with the patient, caregiver, and other health professionals to "promote the safe and effective use of medications and help patients achieve the targeted outcomes from medication therapy."  (www.pharmacist.com)

How do I find Medication Therapy Management (MTM) for my parent?

Here are some good starting points.

•   Check with your pharmacist.  Here is a program I found offered by CVS.  http://www.silverscript.com/en-US/medication-therapy-management-programs.aspx
•   Check with your primary care physician.
•   Check with your local medical-based university or healthcare center.

Is it reimbursable by Medicare?

•   Some insurance plans cover MTM.
•   Medicare D mandates it for certain patients.
•   The Centers for Medicare and Medicaid Services (CMS) targets those who have multiple chronic diseases, are taking multiple Part D drugs and are likely to incur annual costs of $3,000+ for covered Part D drugs.  I like it that the individual must choose to opt-out.Hopefully the opt-out feature raises the level of awareness of the service.

My suggestions for an adult child of an elderly parent:

•   Educate yourself about the value of MTM by speaking with your parent's pharmacist or primary care physician.
•   Determine the best provider of MTM for your parent (based on program and cost).
•   Schedule the service and accompany your parent.  Our aging parents really need our advocacy and support when it comes to the overwhelming world of drugs.