MTM Polypharmacy Assessment & Reduction 4

Question 1

A pharmacy team is designing a polypharmacy reduction program for a long-term care facility. Which metric BEST measures the program's effectiveness over time?

Accepted Answer

Mean number of medications per resident and rate of adverse drug events

Answer

Tracking both the mean medication count and adverse drug event rates provides outcome data reflecting both process and safety improvements.

Question 2

A 68-year-old patient with COPD is taking tiotropium, salmeterol/fluticasone, and albuterol PRN. The physician also prescribes ipratropium. Which pharmacist recommendation is MOST appropriate?

Accepted Answer

Recommend discontinuing ipratropium since tiotropium provides equivalent long-acting anticholinergic coverage

Answer

Tiotropium is a long-acting muscarinic antagonist (LAMA) that duplicates the mechanism of ipratropium (short-acting anticholinergic), making concurrent use therapeutic duplication.

Question 3

Which scenario BEST represents 'problematic polypharmacy' as distinguished from 'appropriate polypharmacy'?

Accepted Answer

A patient taking 3 medications for a single condition with one providing no measurable benefit

Answer

Problematic polypharmacy occurs when medications lack evidence of benefit, have no clear indication, or the risk-benefit ratio is unfavorable, regardless of the total number.

Question 4

A pharmacist is reviewing a patient who takes zolpidem 10 mg nightly for chronic insomnia. Per the Beers Criteria, what is the MOST appropriate recommendation?

Accepted Answer

Recommend cognitive behavioral therapy for insomnia (CBT-I) as first-line and begin a gradual taper of zolpidem

Answer

Benzodiazepine receptor agonists like zolpidem are listed in the Beers Criteria as potentially inappropriate in older adults due to fall and cognitive risks; CBT-I is the evidence-based first-line treatment.

Question 5

When prioritizing which medications to deprescribe first, which framework helps pharmacists rank medications by patient-specific risk and benefit?

Accepted Answer

The GoodPalliativeCare.org.au deprescribing algorithm considering time-to-benefit and life expectancy

Answer

Deprescribing frameworks that consider time-to-benefit relative to patient life expectancy help prioritize which medications to discontinue in patients with limited life expectancy.

(MTM) Medication Therapy Management Certification for Pharmacists Practice Test

(MTM) Medication Therapy Management Certification for Pharmacists Practice Test

MTM Polypharmacy Assessment & Reduction 4