Assessing evidence for MTM quality measure development: a scoping review

Performance measures for health care quality programs should rely on a strong evidence base, given their impact on patients, providers, and payers. The purpose of this review was to assess the literature on the association between medication therapy management (MTM) services and outcomes to substantiate a new quality measure.

Scoping review.

We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. The search included articles published between January 2006 and October 2024. Studies were included if they assessed the impact of Medicare Part D MTM service outcomes, followed Part D program MTM eligibility requirements, and were Medicare beneficiary specific. The search strategy was adapted for use in PubMed and grey literature. Reviewers extracted data using a screening tool developed for this study and used the Grading of Recommendations Assessment, Development, and Evaluation Evidence to Decision framework to determine the certainty of the evidence for risk of bias, indirectness, inconsistency, and imprecision.

Of 424 screened articles, 27 studies met the inclusion criteria and were reviewed for certainty. Of these, 6 (22%) assessed for risk of bias had high levels of certainty that the true effect was similar to the estimated effect, whereas the levels of certainty for directness, consistency, and precision were rated low for all 6 studies.

The association between Part D MTM services and outcomes exists but is not sufficient to support recommendations for a new MTM quality measure. Future research with stronger study designs is warranted to support future measure development.