Medication Therapy Management Annual Review Form

Streamline Your Medication Therapy Management Annual Reviews with Paperform

For pharmacists, pharmacy technicians, healthcare providers, and clinical pharmacy teams, conducting thorough medication therapy management (MTM) annual reviews is essential for optimizing patient outcomes and ensuring medication safety. This comprehensive MTM annual review form template makes it easy to document comprehensive medication reviews (CMRs), track medication-related problems, create action plans, and measure outcomes—all in one professional, easy-to-use digital form.

Why Digital MTM Forms Matter for Healthcare Providers

Traditional paper-based MTM documentation can be time-consuming, difficult to organize, and challenging to analyze for quality improvement initiatives. With Paperform's medication therapy management annual review template, you can:

• Capture complete patient information including demographics, insurance details, and pharmacy contacts in a structured format
• Document comprehensive medication reviews with detailed medication lists, adherence assessments, and clinical findings
• Identify and track medication-related problems using standardized categories and severity ratings
• Create actionable follow-up plans with clear interventions, timelines, and responsible parties
• Measure outcomes and interventions to demonstrate the value of your MTM services
• Generate professional documentation that meets CMS requirements and payer standards

Built for Pharmacy and Clinical Teams

This template is specifically designed for pharmacists, clinical pharmacy specialists, pharmacy benefit management teams, and healthcare organizations that provide medication therapy management services. Whether you're conducting MTM reviews in community pharmacy settings, hospital clinics, or telephonic programs, this form adapts to your workflow.

The form uses conditional logic to show relevant sections based on the patient's specific situation—if medication-related problems are identified, additional fields appear for documentation and intervention planning. This keeps the form streamlined for straightforward reviews while capturing comprehensive details when needed.

Key Features of This MTM Annual Review Template

Patient & Insurance Information Collect essential demographics, contact details, insurance coverage, and preferred pharmacy information to ensure accurate record-keeping and billing.

Comprehensive Medication Review Documentation Document the CMR date, review method (in-person, telephonic, or telehealth), current medication list with adherence assessments, and any allergies or adverse reactions.

Medication-Related Problem Identification Systematically identify and categorize medication-related problems including:

• Indication without medication
• Medication without indication
• Ineffective medication
• Dosage too low or too high
• Adverse drug reactions
• Drug-drug, drug-food, or drug-disease interactions
• Nonadherence issues
• Cost-related problems

Action Plan & Interventions Create clear, documented action plans with specific interventions, recommendations for prescribers, patient education provided, and follow-up timelines.

Outcomes Tracking Measure and document outcomes including problems resolved, clinical improvements, cost savings, and patient satisfaction to demonstrate the value of your MTM services.

Automate Your MTM Workflow with Stepper

Once you've collected MTM review data through Paperform, you can use Stepper to automate the follow-up workflow:

• Automatically send action plan summaries to patients via email or SMS
• Route prescriber recommendations to the appropriate healthcare providers
• Schedule follow-up appointments or check-in calls based on the action plan timeline
• Update your pharmacy management system or electronic health records with review findings
• Generate reports for CMS Star Ratings or payer quality metrics
• Send reminder notifications for medication refills or adherence check-ins

This automation saves hours of administrative work while ensuring consistent, timely follow-up that improves patient outcomes.

Compliance, Security & Integration

Medication therapy management documentation contains sensitive health information that requires robust security. Paperform is SOC 2 Type II compliant and GDPR compliant, with encryption, access controls, and audit trails to protect patient data. While Paperform is not HIPAA compliant, many healthcare organizations use it for internal workflows and patient engagement activities that don't require HIPAA coverage.

The form integrates seamlessly with your existing tools:

• Sync data to your CRM or pharmacy system via Stepper, Zapier, or webhooks
• Export to Google Sheets or Airtable for analysis and reporting
• Send notifications to Slack or Microsoft Teams when high-priority reviews are completed
• Connect with email marketing tools to send educational materials and follow-up reminders

Perfect for Multiple Healthcare Settings

This MTM annual review template works across various practice settings:

• Community pharmacies providing Medicare Part D MTM services
• Health system pharmacies with ambulatory care or clinic-based programs
• Specialty pharmacies managing complex medication regimens
• Telephonic MTM programs conducting remote patient consultations
• Accountable care organizations tracking medication optimization initiatives
• Managed care organizations measuring pharmacy quality metrics

Get Started in Minutes

With Paperform's intuitive editor, you can customize this template to match your organization's specific documentation requirements, branding, and workflow. Add your logo, adjust field labels to match your terminology, or incorporate additional assessment tools like medication adherence scales or patient satisfaction surveys.

Whether you're a solo pharmacist practitioner or part of a large clinical pharmacy team, this medication therapy management annual review form helps you deliver higher-quality care, improve patient outcomes, and demonstrate the value of your services—all while reducing documentation time and administrative burden.

Start using this professional MTM annual review template today and transform how you document and manage medication therapy management services.