FOCUSING RMTAC

1. The Exciting Journey of
MTAC Pharmacist- Focus on
RMTAC
Shahirah Zainudi, RPh. 3960
Pharmacist
Hospital Serdang 1

2. Outine of Presentation
 Introduction of RMTAC
 Milestone of RMTAC in Malaysia
 Jobscope of RMTAC Pharmacist
 Workflow

3. 2

4. • Plan from 9th Malaysia Pharmacy
Programme Health Plan (2006 –
2010)
• In 2004 , Medication Therapy Adherence
Clinics (MTAC) were initiated by the
Pharmaceutical Services
Division,Ministry of Health Malaysia in
ambulatory settings
Medication Therapy Adherence Clinic (MTAC)
3

5. • The objectives
 to optimise drug therapy,
 to improve medication adherence
 to reduce or prevent the occurrence
of adverse events and complications
due to the drug regimen.
 Improve patient understanding of
medicines taken by the patient
Medication Therapy Adherence Clinic (MTAC)
4

6.  MTAC is a clinical pharmacy
service in the Ambulatory Clinic
System which emphasises on
medication management
to improve on QUALITY,
SAFETYand COST-
EFFECTIVENESS of patient care.
 Operated by trained pharmacists
who provide counseling and
education to patients with the
purpose of helping improve the
patient's ability to successfully
manage their condition and prevent
5
Medication Therapy Adherence Clinic (MTAC)

7. MILESTONE OF RMTAC
Year Event
2006 PF went for oversea training
2007 Hospital Melaka setting up as 1st RMTAC hospital
2008 RMTAC services extend to other 6 hospitals
a.H. Selayang, Selangor
b. H. Sultanah Tg Zahirah, KT.
c.H.Sultanah Bahiyah,Kedah
d. H. Sultanah Aminah, JB
e. H. Raja Perempuan Zainab (II), KB
f. H. Seberang Jaya, Penang
2009-2010  RMTAC Flipchart
 1st RMTAC protocol
 PF went to Singapore for RMTAC training
2011-2015  Book on Inhaler Technique
 2nd ed of RMTAC protocol
 Asthma diary
2016-now  More training centers open at each state
 Research
 Module online

9. 6
Medication Therapy Adherence Clinic (MTAC)
16 MTAC with Establised Protocols
Diabet
es
CKD Heart
Failure
Thalassaem
ia
Warfari
n
Post renal
transplant
Hepatitis Pcychiatry
Respira
tory
Dialisis Rheumatol
ogy
Psoriasis
Retrovi
ral
Diseas
e
Neurology
(stroke)
Hemophilia Geriatric

10. 7
WHERE TO DO
THE
COUNSELING?
HOW SHOULD
I START?
WHAT SHOULD
I DOCUMENT ?
WHY SHOULD
I START THE
MTAC?
BACK IN 2007......The journey started

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2. MEET UP THE MATRON , STAFF NURSE
IN-CHARGE OF THE CLINIC & STAFF NURSE IC.
1. REVIEW ON HOW MANY PATIENT NEED
COUNSELING SESSION ~ SMALL RESEARCH
3. DISCUSS ON THE WORKFLOW,
OPERATION HOUR & PLACE TO
COUNSELLED
4. MEET UP SPECIALIAST I/C
5. START MTAC

13. REMEMBER... IN MTAC
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14. 11
Model of MTAC
Team - based model of primary care that delivers
comprehensive, integrated, and patient - centered care that
takes responsibility for the overall health of a patient
 Deliver Better Healthcare by improving medication use,
reduce the risk of ADR
 Improve Patient Health
 Reduce and Control Cost

15. 12

16. AFTER FEW MONTHS....
• 3 NEW TEAM MEMBER...
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• WORKFLOW & MODULE...

17. 14

18.  RMTAC service comprises of few sessions of visits.
 Patients will undergo at least 4 sessions of MTAC to
ensure the effectiveness of these services. (1pre:
3post)
 Patient Selection
5
Medication Therapy Adherence Clinic (MTAC)

19.  First session:
 Pharmacists will interview
patients about the
disease and their
treatment history.
 Patient will also be
assessed on general
knowledge about the
disease and the patient’s
medication. This will allow
pharmacist to identify the
problems faced by the
patient and components
that need to be
5
Medication Therapy Adherence Clinic (MTAC)

20. Medication Therapy Adherence Clinic (MTAC)

21. 19

22. 15
PHARMACIST'S ROLE

23. 18
PHARMACIST'S ROLE

24. 20

25. 21
1. Number of visit = 1pre: 3post visit
 Patient's scheduling
 Maintain statistics
2. Developing Relationship
 Building trust with providers & support staff
 Cooperation from doctors & staff nurse
 Pharmacist- Patient relationship
 Selection of medicine
3. Pharmacy
 Restricted budget for attachments (local or overseas), training @
excellence centers, & short courses
 Manpower:
 Multitasking and variation in job distribution ( types of facilities)
 High turnover rate of pharmacists (transfer,
resign)
 Reluctant to expand job scope

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27. ADVANTAGES BEING RMTAC PHARMACIST
• Increase knowledge and become master in a field
especially as ward/clinical pharmacist
• High opportunity involve in research and collaboration
with physician.
• Good rapport with physician and team on-site.
• High chances for training (subject to cost)
• Satisfaction
– when patient’s condition improving.
– Intervention & recommendation accepted by physician
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CONCLUSION
 Service where u learn to apply your
knowledge and skills handling patient.

31. REFERENCES
• Sameerah. 2008. Slaid presentation title: Implementation of MTAC in Ministry of Health.
• Noraini M. 2014. Slaid presentation title: Clinical Pharmacy in Malaysia:Past ,Present and
Future. Accessed from http://mps.org.my/view_file.cfm?fileid=1572
• http://www.authorstream.com/Presentation/roopadevi52-1801948-role-pharmacist-
counseling-diabetic-patient-imp/
• Berenguer B., La Casa C., de la Matta M.J. and Martin-Calero M.J.. Pharmaceutical Care:
Past, Present and Future. Current Pharmaceutical Design (2004) 10: 3931.
https://doi.org/10.2174/1381612043382521
• https://www.pharmacist.com/medication-therapy-management-services
• Enhancing Access to Medication Therapy Management (MTM) Services to Reduce the
Burden of Diabetes Complicationshttp Accessed from ://main.diabetes.org/dorg/disparities-
partnership-fourm/mtm.pdf
• Medication Therapy Management. Accessed from
https://cqm.pharmacy.ufl.edu/services/mtm /
• Hemat Afifi Sherif., Patient Education & Counseling.2017. Accessed from
https://www.slideshare.net/ouowkw/pharmacist-patient-education-and-counseling
• https://slideplayer.com/slide/6178339/
• https://study.com/academy/lesson/the-pharmacist-patient-relationship.html
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32. JKK RESPIRATORI HSDG RESPIRATORI TEAM