Identify patients that have not achieved clinical goals of therapy.

Understand the patient’s personal medication experience/history and preferences/beliefs.

Identify actual use patterns of all medications including OTCs, bioactive supplements, and prescribed medications.

Assess each medication (in the following order) for appropriateness, effectiveness, safety (including drug interactions), and adherence, focused on achievement of the clinical goals for each therapy.

Identify all drug therapy problems (the gap between current therapy and that needed to achieve optimal clinical outcomes).

Develop a care plan addressing recommended steps, including therapeutic changes needed to achieve optimal outcomes.

Patient agrees with and understands care plan, which is communicated to the prescriber/provider for his/her consent/support.

Document all steps and current clinical status versus goals of therapy.

Follow-up evaluations with the patient are critical to determine effects of changes, reassess actual outcomes, and recommend further  therapeutic changes to achieve desired clinical goals/outcomes. Other team members and personalized (patient-unique) goals of therapy are understood by all team members.

Comprehensive medical management is a reiterative process—care is coordinated with other team members and personalized (patient-unique) goals of therapy are understood by all team members.