The movement toward the adoption of medication therapy management that is focused on managing complex or challenging patient population has been gaining increasing awareness as a means of optimizing medication therapy. This movement is proving to be critical when it comes to trauma patients. There are a myriad of issues whether cognitive, mental, or physical that can be experienced by an individual who experiences a traumatic event, but the implementation of medication therapy management can influence positive patient outcomes.

Medication therapy management is defined as an analytical, consultative, educational, and monitoring service that can be provided by a pharmacist to better facilitate the achievement of positive therapeutic outcomes. The services that can be provided through medication therapy counseling can include a comprehensive medication review, prescriber consultations, patient compliance consultation, and patient education/monitoring, to name a few. Clinical pharmacists evaluate patients' medications, document and resolve drug therapy problems, and identify opportunities for additional medication therapy management services.

Given the fragility and the variety of trauma patients, the aftermath of patient care is critical and the related consultation of ongoing medication therapy is of the utmost importance. Pharmacists must consult with the prescribing provider in order to address any medication conflicts, duplications of therapy on the basis of review of current regimens, and/or cost savings opportunities when appropriate. Although cost-effectiveness may be an important aspect of therapy, it is important to assess the clinical justification and appropriateness of all medication therapies in a patient who presents to a clinical pharmacist for follow-up.

An example of a clinical pharmacist intervention could involve the screening and assessment of potential adverse side effects or reactions that can result from a multitude of medications. For example, the combination of psychotropic medications to either manage sleep disturbances or mental conditions along with the use of cognitive enhancing agents can produce an onslaught of central nervous system effects (eg, drowsiness, dizziness, headache, and lightheadedness). Although some of these effects may be transient in nature, others may persist, which may cause potential reactions that a clinical pharmacist can communicate to the trauma patient.

Pharmacists' estimates of the impact of an medication therapy management program in a large integrated health care system suggest that such a program would be associated with improved clinical outcomes and cost savings as well as high patient satisfaction levels.1 The opportunity to achieve positive therapeutic outcomes takes the conscious effort and vigilance of a pharmacist who is able to recognize patients who would benefit from participating in an effective medication therapy management program. Nurses are encouraged to use the pharmacist consultant to better manage their patients and to ensure the best outcomes of any patient's medication therapy program.

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