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


Ana Soldo

Croatian Chamber Of Pharmacists, HR
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In 2015 Croatia was one of the EU countries with the highest expenditure on medical goods, where pharmaceuticals accounted for more than a quarter of total health expenditure (1). The observed increase in medication use is mainly caused by a continuous increase in the prevalence of chronic diseases among patients and the health expenditure for their treatment (2).

Description of policy context and objective

Evidence from various countries suggests that up to 20% of health spending is wasteful and could be reallocated to better use. To improve patients' outcomes and reduce health expenditure, the introduction of a new patient-centred and pharmacist-led practice, focused on therapy management is deemed urgent. Comprehensive Medication Management (CMM) service is defined as the standard of care that ensures each patient’s medications are individually assessed to determine that each medication is appropriate for the patient, effective for the medical condition, safe given the comorbidities and other medications being taken.

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).

The objective of this presentation is to discuss legal preconditions that need to be met in order to enable successful implementation of CMM service at the primary care level. Secondary objective of this presentation is to elaborate how CMM service can contribute to the efficiency in health expenditure.


Piloting of the CMM services at the Health Centre Zagreb, has brought an opportunity to create a new position for the pharmacist in Croatian health system. 


For CMM service to become a reality in Croatia, Europe and elsewhere, it is of paramount importance to develop policies enabling the development and implementation of these services in a manner that can be reimbursed, reproducible and sustainable. Governments willing to support clinical pharmacists, namely professionals willing and capable to provide this service, are of an utmost importance, as it will only live its full potential when we have well trained and experienced practitioners.


1. OECD/EU (2018), Health at a Glance: Europe 2018: State of Health in the EU Cycle,

2.  Improving Patient Medication Management In Primary Care, Marie Smith, Margherita R. Giuliano, and Michael P. Starkowski;

18.          McBane SE, Dopp AL, Abe A, Benavides S, Chester EA, Dixon DL, et al. Collaborative drug therapy management and comprehensive medication management - 2015. Pharmacotherapy. 2015;

46.          Brajković A, Mucalo I, Vidović T, Gonzaga do Nascimento MM, Balenović A, Protrka I, et al. Implementation of medication management services at the primary healthcare level – a pilot study. Acta Pharm. 2019;69:585–606.

47.          Butler A, Dehner M, Gates RJ, Shane P, Chu M, DeMartini L, et al. Comprehensive Medication Management Programs : 2015 Status in California.


How to Cite: Soldo A. Prerequisites for successful implementation of Comprehensive Medication Management services at a primary care level in Croatia. International Journal of Integrated Care. 2021;21(S1):256. DOI:
Published on 01 Sep 2021.


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