Date of Award


Document Type


Degree Name

Doctor of Pharmacy (PharmD)

First Advisor

Jean Moon, PharmD, FCCP, BCACP

Second Advisor

Todd Lemke, PharmD, CDE


The purpose of this continuous quality improvement project was to implement a pharmacist-led Medication Therapy Management (MTM) clinic in rural, central Minnesota and assess the impact on patients’ healthcare over a six-month period. Patients were identified through the clinic’s diabetes registry, which included patients 18 through 75 years old with a diagnosis of diabetes not meeting all five D5 goals, as recommended by the Minnesota Community Measurements, independently referred by the provider, or be identified by their insurance company as a patient that would benefit from an MTM visit. The D5 focuses on blood pressure and blood sugar control, appropriate statin and aspirin use, and cessation of tobacco products. Referred patients were offered and scheduled for an appointment with the pharmacist. MTM visits were provided both in person and via telephone. The pharmacist identified and documented drug therapy problems (DTPs) and implemented changes, via the system’s clinical pharmacy collaborative practice agreement, to improve patient outcomes. All MTM visits, DTPs, and composite D5 scores were analyzed after the conclusion of the study period. Thirty-one visits were provided by the pharmacist at the clinic between October 1st, 2021 and March 31st, 2022, with 22 unique patients seen. Seventy-three DTPs were identified, with 69 DTPs documented as closed. Of the 22 unique patients seen, 13 patients were reviewed for D5 metrics. Referral processes were created, implemented, and modified over the six-month period to increase patient volume.


A report submitted to the University of Minnesota College of Pharmacy Postgraduate (PGY1) Pharmacy Residency Program