Implementation of medication management services at the primary healthcare level – a pilot study

Abstract

This study employed a mixed-method approach to enable the implementation of comprehensive medication management (CMM) services in Croatia’s primary care setting. Drug therapy problems (DTPs) and factors associated with their occurrence were determined in patients with chronic diseases from January 2018 to April 2019. The pre-implementation stage established the foundations for the early implementation stage, in which the practice was set up, the patients’ recruitment initiated and various challenges identified. During the study period, 86 patients were recruited for CMM provision. Overall, 2.8 DTPs (± 1.6) per patient were identified and the majority (96.2 %) presented with at least one DTP. Multiple regression analysis showed that type 2 diabetic patients (p = 0.025) and patients using five or more medications (p = 0.011) should be prioritized to receive CMM services as potentially they have a higher number of DTPs, and could, therefore, obtain a greater benefit from the service.

Exploring Patients’ Attitudes Toward Deprescribing and Their Perception of Pharmacist Involvement in a European Country: A Cross-Sectional Study

“… 12–14 In Croatia pharmacist-led medication reviews, comprehensive medication management or deprescribing are still seldom used in everyday practice. Currently, comprehensive medication management is available as a pilot project in one primary health care facility, 15 and one university hospital is conducting a project on pharmacist-led medication reconciliation. 16 , 17 These services are still not supported by health policy nor reimbursed.…”

Performance of Pharmacy students in a comprehensive medication management service in a Primary Health Care Setting

“…In addition, chronic diseases are more common among users of CMM services (Mendonça et al, 2016;Ramalho de Oliveira, Brummel & Miller, 2010). The most common disease among the CMM patients was systemic arterial hypertension, also the case in both Brazilian (Mendonça et al, 2016;Santos et al, 2021) and international (Isetts et al, 2008;Ramalho de Oliveira, Brummel & Miller, 2010;Brajković et al, 2019) studies.…”

Prerequisites for successful implementation of Comprehensive Medication Management services at a primary care level in Croatia

“…Published data on CMM services implementation (46) confirms that this service has not been developed or recognized in Europe, as it has been in the Anglo-Saxon countries especially USA and Australia (18,47).…”