Canadian Entry To Practice Canadian Entry To Practice Medication Therapy Management 1 — Questions and Answers
Question 1: What is the primary goal of Medication Therapy Management (MTM) services in community pharmacy practice?
- To increase the number of prescriptions dispensed
- To optimize therapeutic outcomes and minimize medication-related problems (Correct answer)
- To reduce the cost of medications for insurers only
- To promote brand-name drug use
Correct answer: To optimize therapeutic outcomes and minimize medication-related problems
MTM aims to optimize patient therapeutic outcomes by identifying, preventing, and resolving medication-related problems through collaborative care.
Question 2: Which document provides a comprehensive list of all medications a patient is taking, including prescriptions, OTCs, and natural health products?
- Drug Utilization Review report
- Personal Medication Record (PMR) (Correct answer)
- Medication Administration Record
- Adverse Drug Reaction report
Correct answer: Personal Medication Record (PMR)
A Personal Medication Record (PMR) documents all medications a patient takes and is a foundational tool in Medication Therapy Management.
Question 3: A patient is taking warfarin and begins taking St. John's Wort for depression. What is the primary pharmacotherapy concern?
- St. John's Wort increases warfarin levels, raising bleeding risk
- St. John's Wort is a CYP450 inducer that decreases warfarin levels, raising clot risk (Correct answer)
- There is no significant interaction between these agents
- St. John's Wort causes warfarin to be excreted faster via the kidneys
Correct answer: St. John's Wort is a CYP450 inducer that decreases warfarin levels, raising clot risk
St. John's Wort induces CYP2C9 and P-glycoprotein, significantly reducing warfarin plasma levels and increasing the risk of thromboembolic events.
Question 4: During a comprehensive medication review, a pharmacist identifies that a patient is taking two medications from the same drug class. This is categorized as which type of medication-related problem?
- Adverse drug reaction
- Therapeutic duplication (Correct answer)
- Non-adherence
- Inappropriate indication
Correct answer: Therapeutic duplication
Therapeutic duplication occurs when a patient is prescribed two or more medications from the same pharmacological class without clinical justification.
Question 5: What is the STOPP criteria used for in Medication Therapy Management?
- Screening for appropriate antibiotic use in pediatrics
- Identifying potentially inappropriate prescribing in older adults (Correct answer)
- Evaluating adherence to chronic disease guidelines
- Assessing renal dose adjustment requirements
Correct answer: Identifying potentially inappropriate prescribing in older adults
STOPP (Screening Tool of Older Person's Prescriptions) identifies potentially inappropriate medications commonly prescribed to older adults that may cause harm.
Question 6: A patient with type 2 diabetes has an HbA1c of 9.2% despite being on metformin 1000 mg twice daily. What is the most appropriate MTM action?
- Discontinue metformin and switch to diet only
- Recommend intensification of therapy by adding another antidiabetic agent (Correct answer)
- Advise the patient to reduce carbohydrate intake without medication change
- Refer directly to the emergency department
Correct answer: Recommend intensification of therapy by adding another antidiabetic agent
An HbA1c of 9.2% indicates suboptimal glycemic control, and intensification by adding a second antidiabetic agent is consistent with Canadian diabetes management guidelines.
Canadian Entry To Practice Canadian Entry To Practice Medication Therapy Management 1
What is the primary goal of Medication Therapy Management (MTM) services in community pharmacy practice?