To develop the MTM Adaptability Framework for pharmacist MTM delivery, (2) to examine the impact of an educational intervention informed by the Framework on MTM completion rates over a 2-year period, and (3) to explore pharmacists' knowledge and beliefs about MTM and MTM implementation self-efficacy pre- and post-intervention. This prospective, mixed-methods study combines a quasi-experimental, one-group pretest-posttest quantitative investigation with sequential explanatory qualitative interviews using semi-structured key informant interviews. US grocery pharmacy chain has 93 community pharmacies in Tennessee, Kentucky, and Alabama. Comprehensive and targeted medication reviews (CMRs) and pharmacist perceptions are used to calculate MTM completion rates.

The educational intervention on MTM adaption in community pharmacies increased MTM completion rates by 11.4%. The difference was substantial (46.92% vs. 58.3%; p < 0.001). Semi-structured interview responses were mapped against CFIR and included themes: “knowledge and beliefs about MTM (pre-intervention),” “self-efficacy for MTM implementation (pre-intervention),” and “knowledge and beliefs about MTM (post-intervention).” Data from these methods showed that addressing MTM delivery adaptation boosts MTM completion rates (quantitative data) and improves MTM feasibility and self-efficacy (interviews). As part of an implementation plan, an educational intervention about MTM adaptation to a chain community pharmacy setting increased MTM completion rates. Future study should examine how mixed implementation techniques affect MTM success.