Comprehensive Medication Management Services as a Solution to Medication Mismanagement: A European Perspective

Abstract

Due to an increase in the prevalence of chronic diseases, medication use and their cost is rising rapidly. This scenario render chronic patients at an increased risk of experiencing drug therapy problems, subsequently leading to unfavourable clinical and economic outcomes. Thus, to ensure patients’ optimal medication use and improve their clinical outcomes, a comprehensive and systematic management of medications is deemed crucial. Hence, Comprehensive Medication Management (CMM) services offered by trained pharmacists can fill this gap by decreasing the unnecessary and often harmful use of medicines and consequent resulting complications. Collaborative practice between pharmacists and general practitioners, together with patients’ active participation in the definition of treatment regimens, plays an important role in the effectiveness of CMM services. CMM services is defined as the standard of care that ensures each patient’s medications (prescription, non-prescription, alternative, traditional, vitamins, or nutritional supplements) 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 taken, and that the patient is able to take them as intended. It includes an individualized care plan that achieves the intended goals of therapy with appropriate follow-up to determine actual patient outcomes. Apart from the USA, several countries (e.g. Australia, Canada and Brazil) have managed to integrate CMM services into their existing health care system at the primary care level. However, in Europe, in spite of the widespread recognition of the need for medication management services, initiation and implementation of CMM services are lagging behind. Hence, for CMM services to become a reality in Europe and elsewhere, numerous prerequisites need to be accomplished, including policies and legal regulations supporting the provision of CMM services on a much larger scale, clearly defined and standardized professional practice and common language shared among the pharmacists, and well trained and experienced practitioners providing full-time, direct patient care.