Evaluation of pharmacists' barriers to the implementation of medication therapy management services.

Objectives: To assess pharmacists' actual and perceived barriers to implementing medication therapy management (MTM) services in the outpatient setting and to assess demographic and other factors associated with identified barriers.

Design: Cross-sectional study.

Setting: United States in 2007.

Participants: 970 pharmacists practicing in an outpatient setting.

Intervention: E-mail invitation to participate in an Internet-based survey.

Main Outcome Measures: Barriers to implementing MTM, practice characteristic influences on barriers, and personal characteristic influences on barriers.

Results: 776 of the 970 respondents (80.0%) were providing MTM or direct patient care services. Of respondents, 35% were compensated and 45% were not compensated for providing MTM services they provided to patients. The most common barriers identified for pharmacists providing MTM services with or without compensation were related to compensation. The most common barriers identified for those interested in providing MTM services were lack of additional staffing (89.6%) and poor access to medical information (84.0%). Pharmacists providing MTM with compensation were significantly less likely to agree with barriers relating to management, documentation, and compensation compared with those providing MTM without compensation. Those providing MTM with compensation were less likely to agree with most barriers compared with pharmacists who were interested in providing MTM services. Pharmacists practicing in a noncommunity setting were less likely to agree with barriers related to interprofessional relationships and documentation.

Conclusion: These results show that the most important barriers to implementing MTM services in the outpatient setting identified by pharmacist survey respondents were related to interprofessional relationships, documentation, and compensation. Despite the resources available to pharmacists, barriers continue to hinder the expansion of MTM and direct patient care services.