MTM Patient Assessment & Care Planning 2 — Questions and Answers
Question 1: A pharmacist conducting an MTM comprehensive medication review (CMR) identifies that a patient with type 2 diabetes has an A1C of 9.8% despite being on metformin 1000 mg twice daily. What is the most appropriate next step in the care planning process?
- Document the finding and schedule a follow-up in 6 months
- Identify a drug therapy problem related to the need for additional antidiabetic therapy (Correct answer)
- Immediately discontinue metformin and recommend insulin
- Refer the patient to a dietitian without updating the medication action plan
Correct answer: Identify a drug therapy problem related to the need for additional antidiabetic therapy
An A1C of 9.8% despite maximum-dose metformin indicates uncontrolled diabetes, which represents a drug therapy problem requiring additional therapy.
Question 2: During patient assessment, which validated tool is most commonly used to screen for depression in MTM patients?
- Beers Criteria
- STOPP/START criteria
- Patient Health Questionnaire-9 (PHQ-9) (Correct answer)
- Morisky Medication Adherence Scale (MMAS-8)
Correct answer: Patient Health Questionnaire-9 (PHQ-9)
The PHQ-9 is a validated, widely used screening tool for depression severity that is appropriate in MTM practice.
Question 3: A patient presents for MTM with a blood pressure of 158/96 mmHg. He is currently taking lisinopril 10 mg daily. According to JNC guidelines, which drug therapy problem category best describes this situation?
- Unnecessary drug therapy
- Needs additional drug therapy
- Dosage too low (Correct answer)
- Adverse drug reaction
Correct answer: Dosage too low
The patient is on an appropriate antihypertensive but has uncontrolled BP, suggesting the current dose is insufficient.
Question 4: Which component of the SOAP note format is used to document the pharmacist's assessment of identified drug therapy problems?
- S — Subjective
- O — Objective
- A — Assessment (Correct answer)
- P — Plan
Correct answer: A — Assessment
The Assessment section of a SOAP note is where the pharmacist documents identified problems and their clinical significance.
Question 5: When completing a medication action plan (MAP) for a patient, what is the primary goal of this document?
- To provide the prescriber with a billing summary
- To give the patient a prioritized list of actions they can take to manage their own health (Correct answer)
- To document all drug therapy problems for payer review
- To serve as an internal pharmacist workflow checklist
Correct answer: To give the patient a prioritized list of actions they can take to manage their own health
The MAP is a patient-centered document that lists self-management actions in plain language to engage the patient in their care.
Question 6: A 72-year-old patient takes diphenhydramine nightly for insomnia. Which assessment tool most directly supports identifying this as a potentially inappropriate medication?
- CAGE questionnaire
- American Geriatrics Society Beers Criteria (Correct answer)
- Cockcroft-Gault equation
- ASCVD Risk Calculator
Correct answer: American Geriatrics Society Beers Criteria
The Beers Criteria specifically identifies diphenhydramine as a potentially inappropriate medication for older adults due to anticholinergic effects.
Question 7: In the context of MTM care planning, what does 'goal setting' primarily involve?
- Setting reimbursement targets for the MTM service
- Establishing measurable therapeutic outcomes collaboratively with the patient (Correct answer)
- Determining the number of MTM sessions required per year
- Defining prescriber-only targets without patient input
Correct answer: Establishing measurable therapeutic outcomes collaboratively with the patient
Goal setting in MTM involves collaborating with the patient to establish specific, measurable therapeutic outcomes tied to identified drug therapy problems.
MTM Patient Assessment & Care Planning 2
A pharmacist conducting an MTM comprehensive medication review (CMR) identifies that a patient with type 2 diabetes has an A1C of 9.8% despite being on metformin 1000 mg twice daily.
What is the most appropriate next step in the care planning process?