Medication Therapy Management (MTM) represents a cornerstone of modern pharmacy practice, shifting the focus from dispensing to comprehensive patient-centered care. For PharmD students, mastering MTM principles is crucial for improving patient outcomes, reducing medication-related problems, and enhancing interprofessional collaboration. This quiz is designed to test your foundational knowledge of the five core elements of MTM, patient communication strategies, documentation, and the operational aspects of providing these vital services in various practice settings.
1. What are the five core elements of the Medication Therapy Management (MTM) service model as defined by the pharmacy profession?
- Prescribing, Dispensing, Counseling, Billing, and Follow-up
- Medication Therapy Review, Personal Medication Record, Medication-related Action Plan, Intervention and/or Referral, and Documentation and Follow-up
- Patient Assessment, Formulary Management, Drug Utilization Review, Clinical Intervention, and Patient Education
- Diagnosis, Treatment, Monitoring, Evaluation, and Adherence Counseling
Answer: Medication Therapy Review, Personal Medication Record, Medication-related Action Plan, Intervention and/or Referral, and Documentation and Follow-up
2. A comprehensive medication review (CMR) is best described as:
- A quick check for drug interactions at the point of dispensing.
- A systematic process of collecting patient-specific information and assessing medications to identify and resolve medication-related problems.
- A review of a patient’s profile to ensure they are taking the most affordable medications.
- The creation of a list of all of a patient’s medications.
Answer: A systematic process of collecting patient-specific information and assessing medications to identify and resolve medication-related problems.
3. What is the primary purpose of a Personal Medication Record (PMR)?
- To serve as the official legal record for the pharmacy.
- To be a comprehensive and accurate list of all medications the patient is taking, intended for the patient’s use.
- To track inventory of medications within the pharmacy.
- To communicate recommendations directly to the physician.
Answer: To be a comprehensive and accurate list of all medications the patient is taking, intended for the patient’s use.
4. A Medication-related Action Plan (MAP) is a document created for the:
- Physician, to request a change in therapy.
- Pharmacist, to document interventions.
- Patient, to guide them in tracking and managing their medications and health goals.
- Insurance company, to justify the cost of MTM services.
Answer: Patient, to guide them in tracking and managing their medications and health goals.
5. Which of the following is an essential component of the “Intervention and/or Referral” core element of MTM?
- Dispensing the patient’s monthly medications.
- Collaborating with the patient’s prescriber to resolve a drug therapy problem.
- Providing the patient with a copy of their PMR.
- Scheduling a follow-up appointment with the patient.
Answer: Collaborating with the patient’s prescriber to resolve a drug therapy problem.
6. The final core element of MTM, “Documentation and Follow-up,” is critical for:
- Ensuring continuity of care and billing for services.
- Meeting state board of pharmacy inspection requirements only.
- Marketing MTM services to new patients.
- Ordering new medications for the pharmacy.
Answer: Ensuring continuity of care and billing for services.
7. Which questioning technique is designed to help pharmacists gather comprehensive information about a patient’s symptoms and condition during a self-care consultation?
- SBAR
- SOAP
- SCHOLAR-MAC
- ECHO
Answer: SCHOLAR-MAC
8. Motivational interviewing is a patient-centered communication style primarily used to:
- Quickly gather a patient’s medication history.
- Persuade a patient to accept the pharmacist’s recommendation without question.
- Direct the patient on the single best course of action.
- Help patients explore and resolve their ambivalence about behavior change.
Answer: Help patients explore and resolve their ambivalence about behavior change.
9. In the context of MTM, what is a “drug therapy problem”?
- Any medication that is not a preferred brand name.
- An event or circumstance involving medication therapy that actually or potentially interferes with desired health outcomes.
- A patient’s refusal to take a prescribed medication.
- Any side effect experienced by a patient, regardless of severity.
Answer: An event or circumstance involving medication therapy that actually or potentially interferes with desired health outcomes.
10. Which of the following is an example of an “unnecessary drug therapy” problem?
- A patient taking a lower dose of a statin than recommended by guidelines.
- A patient taking two drugs with the same mechanism of action for the same indication.
- A patient who cannot afford their brand-name inhaler.
- A patient experiencing a common, mild side effect from a new medication.
Answer: A patient taking two drugs with the same mechanism of action for the same indication.
11. A patient with hypertension is prescribed a non-selective beta-blocker, but they also have asthma. This is an example of which type of drug therapy problem?
- Dosage too low
- Adverse drug reaction
- Contraindication or need for a safer alternative
- Non-adherence
Answer: Contraindication or need for a safer alternative
12. When a pharmacist identifies a significant drug therapy problem requiring a change in prescription, the most appropriate next step is to:
- Tell the patient to stop taking the medication immediately.
- Contact the patient’s prescriber with a specific recommendation.
- Dispense the medication and hope the patient is okay.
- Change the prescription in the computer system without consultation.
Answer: Contact the patient’s prescriber with a specific recommendation.
13. What is a key difference between a comprehensive medication review (CMR) and a targeted medication review (TMR)?
- A CMR is for new patients only, while a TMR is for established patients.
- A CMR is a holistic review of all of a patient’s medications, while a TMR focuses on a specific or potential drug therapy problem.
- A CMR can only be billed to Medicare, while a TMR can be billed to any insurer.
- A CMR is conducted by a physician, while a TMR is conducted by a pharmacist.
Answer: A CMR is a holistic review of all of a patient’s medications, while a TMR focuses on a specific or potential drug therapy problem.
14. Under Medicare Part D, which of the following patients would most likely be eligible for MTM services?
- A patient with one chronic condition taking one medication.
- A healthy patient taking no chronic medications.
- A patient with multiple chronic conditions, taking numerous Part D medications, who is likely to incur high annual costs.
- A patient who only uses over-the-counter medications.
Answer: A patient with multiple chronic conditions, taking numerous Part D medications, who is likely to incur high annual costs.
15. What does the “S” in SWOT analysis stand for when developing a business plan for MTM services?
- Services
- Strategy
- Strengths
- Stakeholders
Answer: Strengths
16. The “ECHO” model in pharmacoeconomics is used to evaluate the outcomes of MTM services. What does ECHO stand for?
- Efficacy, Cost, Health, and Outcomes
- Economic, Clinical, and Humanistic Outcomes
- Evaluation, Cost, and Humanistic Objectives
- Economic, Collaborative, and Holistic Outcomes
Answer: Economic, Clinical, and Humanistic Outcomes
17. A reduction in hospital admission rates due to improved medication adherence after MTM services is an example of which type of outcome in the ECHO model?
- Economic
- Clinical
- Humanistic
- Collaborative
Answer: Economic
18. An improvement in a patient’s HbA1c level is an example of which type of outcome in the ECHO model?
- Economic
- Clinical
- Humanistic
- Subjective
Answer: Clinical
19. A patient reporting a better quality of life and greater satisfaction with their treatment is an example of which type of outcome in the ECHO model?
- Economic
- Clinical
- Humanistic
- Objective
Answer: Humanistic
20. Which of the following is a significant barrier to the widespread implementation of MTM services?
- Lack of evidence that MTM improves outcomes.
- Pharmacist refusal to participate in patient care.
- Issues with reimbursement and lack of standardized billing codes.
- Absence of patients with chronic diseases.
Answer: Issues with reimbursement and lack of standardized billing codes.
21. When creating a Personal Medication Record (PMR), what information should be included for each medication?
- Drug name and strength only.
- Drug name, indication, dose, and prescriber.
- Drug name, dose, instructions, indication, and start/stop dates.
- Drug name and pharmacy where it was filled.
Answer: Drug name, dose, instructions, indication, and start/stop dates.
22. During a CMR, a patient mentions they use an herbal supplement for sleep. What is the pharmacist’s most appropriate action?
- Ignore the information as it is not a prescription medication.
- Tell the patient to stop taking all supplements immediately.
- Include the herbal supplement in the PMR and assess it for potential interactions or problems.
- Advise the patient that supplements are not effective.
Answer: Include the herbal supplement in the PMR and assess it for potential interactions or problems.
23. The “assess” step of the Pharmacists’ Patient Care Process (PPCP) corresponds most closely to which part of the MTM core elements model?
- Creating the Medication-related Action Plan (MAP).
- The entire process of the Medication Therapy Review (MTR).
- Documenting the encounter.
- Referring the patient to a specialist.
Answer: The entire process of the Medication Therapy Review (MTR).
24. The primary goal of documenting MTM services is to:
- Create a complex report that is difficult for others to understand.
- Communicate the value of the pharmacist’s services and ensure continuity of care.
- Meet a minimum word count for the patient’s chart.
- Practice typing skills.
Answer: Communicate the value of the pharmacist’s services and ensure continuity of care.
25. A pharmacist is preparing to conduct a CMR for an elderly patient with low health literacy. Which strategy would be most effective?
- Using complex medical jargon to sound more professional.
- Speaking quickly to get through the material faster.
- Using simple language, open-ended questions, and the teach-back method.
- Providing only written materials without any verbal explanation.
Answer: Using simple language, open-ended questions, and the teach-back method.
26. In a SWOT analysis for an MTM service, an “Opportunity” could be:
- A competing pharmacy that already offers MTM.
- The high cost of MTM software.
- A new local physician group that is open to collaborating with pharmacists.
- Lack of pharmacist time to perform MTM.
Answer: A new local physician group that is open to collaborating with pharmacists.
27. What is the main difference between “adherence” and “compliance”?
- There is no difference; the terms are interchangeable.
- Compliance is measured by the physician; adherence is measured by the pharmacist.
- Compliance implies the patient passively follows orders, while adherence implies the patient is an active, willing partner in their care.
- Adherence applies to chronic medications, while compliance applies to acute medications.
Answer: Compliance implies the patient passively follows orders, while adherence implies the patient is an active, willing partner in their care.
28. A patient is prescribed metformin for type 2 diabetes but is not taking it because of gastrointestinal side effects. This is primarily an issue of:
- Indication
- Effectiveness
- Safety/Tolerability
- Cost
Answer: Safety/Tolerability
29. What is a “brown bag review”?
- A review of a new drug conducted by the FDA.
- A type of inventory management system in a pharmacy.
- A session where a patient brings all their medications, including OTCs and supplements, to the pharmacy for a review.
- A confidential peer-review process for pharmacists.
Answer: A session where a patient brings all their medications, including OTCs and supplements, to the pharmacy for a review.
30. The “To-Do List” for the patient is another name for which core MTM element?
- Personal Medication Record (PMR)
- Medication-related Action Plan (MAP)
- Comprehensive Medication Review (CMR)
- Documentation and Follow-up
Answer: Medication-related Action Plan (MAP)
31. When documenting an MTM encounter, using a standardized format like a SOAP note is beneficial because it:
- Is the only format accepted by insurance companies.
- Provides a clear, organized, and widely understood method of communication among healthcare providers.
- Is intentionally vague to protect patient privacy.
- Eliminates the need for a follow-up appointment.
Answer: Provides a clear, organized, and widely understood method of communication among healthcare providers.
32. Which of the following best describes the role of “follow-up” in the MTM process?
- A one-time call to the patient to see if they picked up their prescription.
- A scheduled check-in to monitor progress towards goals identified in the MAP and assess for new problems.
- The final step that ends the pharmacist-patient relationship.
- A process handled exclusively by the patient’s physician.
Answer: A scheduled check-in to monitor progress towards goals identified in the MAP and assess for new problems.
33. Quality performance measures in MTM are used to:
- Punish pharmacists who do not meet quotas.
- Quantify the impact of MTM services on patient health and resource utilization.
- Increase the administrative burden on pharmacies.
- Track the number of prescriptions dispensed per hour.
Answer: Quantify the impact of MTM services on patient health and resource utilization.
34. A key skill for a pharmacist providing MTM is the ability to quickly and efficiently access and evaluate:
- The latest celebrity health trends.
- The pharmacy’s daily sales reports.
- Current, evidence-based clinical guidelines and drug information resources.
- The social media profiles of patients.
Answer: Current, evidence-based clinical guidelines and drug information resources.
35. Cultural competency in MTM is essential for:
- Treating all patients with the same standardized approach.
- Building trust and ensuring communication is respectful and effective for diverse patient populations.
- Learning to speak multiple languages fluently.
- Applying stereotypes to predict patient behavior.
Answer: Building trust and ensuring communication is respectful and effective for diverse patient populations.
36. A needs assessment for establishing a new MTM service should primarily focus on:
- The pharmacist’s personal interests.
- The number of windows in the pharmacy.
- The target patient population and the unmet medication-related needs in the community.
- The color of the pharmacy’s logo.
Answer: The target patient population and the unmet medication-related needs in the community.
37. Which of the following is an example of an open-ended question?
- “Are you taking your blood pressure medication every day?”
- “Do you have any questions?”
- “Can you tell me how you are taking your blood pressure medication?”
- “Is your blood pressure medication working for you?”
Answer: “Can you tell me how you are taking your blood pressure medication?”
38. The American Pharmacists Association (APhA) provides a well-known certificate training program for:
- Sterile Compounding
- Delivering Medication Therapy Management Services
- Pharmacy Law and Ethics
- Nuclear Pharmacy
Answer: Delivering Medication Therapy Management Services
39. Identifying that a patient needs a specific immunization, such as the pneumococcal vaccine, and referring them to their physician or providing it at the pharmacy is an example of what MTM activity?
- Identifying a drug therapy problem.
- Intervention to promote preventive care.
- Creating a Personal Medication Record.
- Completing a SWOT analysis.
Answer: Intervention to promote preventive care.
40. What is a key challenge when providing MTM to patients in special populations, such as geriatrics or pediatrics?
- These populations rarely take medications.
- Physiological differences that affect pharmacokinetics and pharmacodynamics require more careful assessment.
- There are no clinical guidelines for these populations.
- Insurance never covers MTM for these groups.
Answer: Physiological differences that affect pharmacokinetics and pharmacodynamics require more careful assessment.
41. The step of creating a reconciled medication list for the patient is part of which MTM core element?
- Intervention and/or Referral
- Documentation and Follow-up
- Personal Medication Record (PMR)
- Medication Therapy Review (MTR)
Answer: Personal Medication Record (PMR)
42. Which component of the MTM process ensures that the pharmacist, patient, and other providers are all on the same page regarding the patient’s medications?
- The Medication-related Action Plan (MAP)
- The Personal Medication Record (PMR)
- The process of Documentation
- Both the PMR and MAP, along with clear documentation and communication.
Answer: Both the PMR and MAP, along with clear documentation and communication.
43. A patient says, “I know I should quit smoking, but I just enjoy it too much.” This is an example of:
- Adherence
- Ambivalence
- Acceptance
- Activation
Answer: Ambivalence
44. The primary goal of a CMR is to:
- Increase prescription volume for the pharmacy.
- Identify and resolve drug therapy problems to optimize therapeutic outcomes.
- Fulfill a legal requirement with minimal effort.
- Convince patients to switch to more expensive drugs.
Answer: Identify and resolve drug therapy problems to optimize therapeutic outcomes.
45. Which of the following would be considered a “Weakness” in a SWOT analysis for an existing pharmacy looking to start MTM services?
- A growing elderly population in the area.
- Lack of a private or semi-private area for patient consultations.
- A strong relationship with local doctors.
- The pharmacist has completed an MTM certification program.
Answer: Lack of a private or semi-private area for patient consultations.
46. When a patient needs a non-prescription therapy, the pharmacist’s recommendation is part of which core element?
- Medication Therapy Review
- Personal Medication Record
- Intervention and/or Referral
- Documentation and Follow-up
Answer: Intervention and/or Referral
47. Follow-up reviews for MTM are often conducted on a quarterly basis to:
- Meet the requirements of the patient’s insurance plan.
- Assess progress, address new issues, and ensure continuity of care.
- Allow the pharmacy to bill for another service.
- Check if the patient has moved to a different pharmacy.
Answer: Assess progress, address new issues, and ensure continuity of care.
48. Why is it important to include over-the-counter (OTC) medications in a Comprehensive Medication Review?
- They can cause significant drug interactions and adverse effects.
- They are usually very expensive.
- It is a legal requirement in all 50 states.
- They are a primary driver of pharmacy profits.
Answer: They can cause significant drug interactions and adverse effects.
49. An effective Medication-related Action Plan (MAP) should be:
- Complex and written in technical medical language.
- Patient-centric, collaborative, and easy for the patient to understand and use.
- A generic handout that is the same for every patient.
- A document that is only shared with the patient’s physician.
Answer: Patient-centric, collaborative, and easy for the patient to understand and use.
50. The ultimate measure of success for any MTM service is:
- The number of interventions performed.
- The amount of revenue generated.
- The positive impact on the patient’s health and well-being.
- The length of the documentation report.
Answer: The positive impact on the patient’s health and well-being.
I am a Registered Pharmacist under the Pharmacy Act, 1948, and the founder of PharmacyFreak.com. I hold a Bachelor of Pharmacy degree from Rungta College of Pharmaceutical Science and Research. With a strong academic foundation and practical knowledge, I am committed to providing accurate, easy-to-understand content to support pharmacy students and professionals. My aim is to make complex pharmaceutical concepts accessible and useful for real-world application.
Mail- Sachin@pharmacyfreak.com