Acta Pharm. 69 (2019) 585-606

 

full paper

Original research paper

 

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

ANDREA BRAJKOVIĆ, IVA MUCALO, TONI VIDOVIĆ, MARIANA MARTINS GONZAGA DO NASCIMENTO, ANTONIJA BALENOVIĆ, INO PROTRKA and DJENANE RAMALHO DE OLIVEIRA

imucalo@pharma.hr

1 University of Zagreb Faculty of Pharmacy and Biochemistry, Zagreb, Croatia

2 Zagreb City Pharmacy, Zagreb, Croatia

3 Centre for Pharmaceutical Care Studies (Centro de Estudos Atencao Farmaceutica), Federal University of Minas Gerais, Belo Horizonte, MG, Brazil

4 Health Centre Zagreb – Centre, Zagreb, Croatia

Accepted July 23, 2019

Published online September 6, 2019

 

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.

 

Keywords: comprehensive medication management services, drug therapy problems, risk factors, pharmaceutical care, primary care, implementation stage