Medication therapy management (MTM) is medical care provided by pharmacists whose aim is to optimize drug therapy and improve therapeutic outcomes for patients. (i) To Implement MTM service at a tertiary care hospital. (ii) Identification of Barriers in Implementation of the program. (iii) Assessment of Outcomes of MTM service. (iv) Follow up of the service, a prospective study was conducted in inpatient departments of Cardiology, General medicine and Nephrology Departments. Patient demographics and drugs prescribed data were collected and analysed. Along with this interaction with the patient were also done whenever required. Collection of patients details like demographics, medical, surgical history, current and past medical history. Comprehensive review of the medications (MTR), preparation of personal medication record (PMR), development of patient focussed medication action plan (MAP) and providing to the patient. Discussion and meeting with other health care professionals about the optimization of therapy. To conclude, it is evident from the present study that, MTM services provided by the pharmacist/student pharmacist suggests the need of clinical pharmacist in every hospital setting to meet the standard criteria in minimizing the risk of medication-related problems and improving the patient health outcome for better quality of life.
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