Annex: National experiences from PGEU members

Austria: Community pharmacies can identify cardiovascular risk factors

A scientific study, conducted by the Medical University of Vienna and recently published in “Preventive Medicine Reports”, finds that simple screening tests in pharmacies can identify cardiovascular risk factors. The study highlights the potential role of community pharmacies in the prevention of cardiovascular diseases and received attention in the Austrian media. The aim of the study was to determine the proportion of individuals with an unrecognized risk of cardiovascular diseases among patients in community pharmacies.

After completing mandatory training, pharmacists carried out voluntary point-of-care tests on their walk-in patients over 18 years of age. Over a period of 2 months in late 2024, 62 community pharmacies in Vienna participated in the study, gathering data of 469 participants, of which 445 met the eligibility criteria. Participants were charged 10 Euros for the point-of-care testing. The cardiovascular risk was calculated by measuring the HbA1c value (blood sugar) and/or the Systematic Coronary Risk Evaluation 2 (SCORE2) based on age, smoking status, systolic blood pressure, total cholesterol, and HDL cholesterol. The Body Mass Index (BMI) was also included. HbA1c and cholesterol levels from the blood were determined in the pharmacies using standard measuring devices. Blood pressure measurement was taken after a ten-minute rest period.

Results were communicated to participants both verbally and in written form. Participants identified with increased cardiovascular risk factors were advised to consult their physicians or a medical institution. However, the study aligns with prior evidence regarding medical follow-up measures: despite personalized recommendations only about half of the at-risk participants, who were again contacted at a later stage, reported undergoing medical follow-up.

Link to the study: Point-of-care testing of cardiovascular risk factors in Viennese community pharmacies: A cross-sectional study – PubMed

Denmark: Pharmacies run adherence support programs for patients on statins and antihypertensive medicines, improving treatment outcomes.

All pharmacies in Denmark are obliged to offer two services to patients with a chronic diagnosis (which includes patients with cardiovascular diseases): the New Medicine Service and the Compliance Service.

New Medicine Service

Since January 2016, community pharmacies have offered this service. It is tailored to patients who have been diagnosed with a chronic disease within the last six months and prescribed new medicine against the newly diagnosed chronic disease. This service is based in a pharmacist-patient conversation, that provides the patient with further information in order to correctly start their treatment. The consultation is based on the patient’s needs and adapted by the pharmacist. The service consists in two parts: a 10-minute conversation at the start of the therapy, followed by a new consultation 2-4 weeks after the first one. The consultation is free for the patient, and the pharmacy is paid for the service by the state.

Compliance Service

Since April 2018 community pharmacies have offered this service. It is available to patients who have been taking medicines for chronic diseases for more than 6 months and experienced problems with compliance or were recently discharged from a hospital with changes in medication or starting dose dispensing aids. The purpose of the service is to help the patient become therapy-compliant. The service is based in a consultation, in which pharmacists apply different solutions that are personalized to each patient, which may differ depending on the reason why the patient is not compliant. The service is based in two parts: a 10-minute conversation at the start of the therapy, followed by a new consultation 2-4 weeks after the first one. The consultation is free for the patient, and the pharmacy is paid for the service by the state.

France: reducing CVD risks linked to influenza and to patients under anticoagulants

Ensuring vaccination against seasonal influenza: Vaccination is one of the services that can be provided by French pharmacists who have received prior training. Authorised community pharmacists are permitted to prescribe and administer seasonal flu vaccines to individuals aged 11 years and older, whether or not they are targeted by vaccination recommendations.

The service, which had started as a limited pilot in 2017, quickly gained traction. In the last vaccination campaign (2024-2025), 6.6 million patients got vaccinated in pharmacies, with 90% of pharmacies active in vaccination. And only 2 weeks after the start of the current vaccination campaign (2025-2026), 2 million people had already requested to be and were vaccinated in a French community pharmacy.

More information is available here and here.

Monitoring patients on oral anticoagulants: Treatment with oral anticoagulants requires particular vigilance to prevent the risks of hemorrhage and thromboembolism. In addition to medical and biological monitoring, French community pharmacists may offer patients undergoing treatment personalized support. This support service covered by the National Health Insurance includes an initial consultation to assess the patient’s understanding of the treatment and their adherence, followed by several themed consultations tailored to their identified needs.

During these interviews, pharmacists help the patient to understand: the essential concepts related to their treatment and the role of their oral anticoagulant (vitamin K antagonist or new oral anticoagulant); how to take these medicines; what to do if they forget to take it; the importance of following their treatment properly; the importance of having their INR checked regularly (for patients treated with VKAs) and monitoring for any bleeding; medicines they should avoid; precautions to take in everyday life, etc. The support service was launched for VKAs in 2013, then also for new oral anticoagulants in 2016.

More information is available here, here and here.

Germany: Community pharmacies provide blood pressure control services for patients with diagnosed hypertension to support treatment adherence and refer them to their GP if elevated readings are detected.

In Germany, the remunerated cognitive pharmaceutical service (CPS) “Blood Pressure Control” was introduced nationwide to strengthen the role of community pharmacies in the management of hypertension. The service builds directly on the findings of a national research project that developed and validated referral recommendations for pharmacists, embedded in a guideline worksheet. This worksheet structure blood pressure (BP) measurement, documentation, and risk classification according to a traffic light system (green–yellow–red), supporting appropriate referral and communication with physicians.

The CPS targets patients with diagnosed hypertension who take at least one prescribed antihypertensive medication. It may be provided by pharmacists once every 12 months, starting two weeks after therapy initiation, or earlier if antihypertensive medication is changed. BP is measured after a 5-minute rest with three seated readings at one- to two-minute intervals; the mean of the last two measurements is documented on a standardized worksheet, together with pulse rate and relevant patient information. If elevated or unusually low BP values are detected, the patient is referred to their general practitioner in accordance with the guideline recommendations.

The German Pharmacists’ Association (ABDA) has analyzed nearly 700 documented services. The data show that the service primarily identifies patients with insufficient BP control: 55% of participants had readings in the red range (requiring physician review within four weeks), 30% in the yellow range (potentially too low BP), and only 15% within the target range (green). Alarmingly, 6% presented with BP values exceeding 180/110 mmHg, indicating a medical emergency requiring immediate attention.

These findings demonstrate that community pharmacies can make a substantial contribution to the early detection and better control of hypertension. The structured, guideline-based process ensures consistent quality and strengthens interprofessional collaboration between pharmacists and physicians, thus supporting national public health goals in cardiovascular prevention and chronic disease management.

Italy: The pharmacy network offers telemedicine services for monitoring cardiac diseases to patient in their community.

In Italy, telemedicine services (TMS) have been offered by community pharmacies on a private basis or on a pilot basis at Regional Health Service charge. There are current developments to include these services into regional public health regime schemes.

On 1st January 2025, TMS were offered by 11.312 community pharmacies (about 57% of all Italian community pharmacies). Italian pharmacies connected to 3 different main networks performed 904.601 different services [electrocardiograms (about 64% of the total performances), cardiac Holter monitoring and 24-hour blood pressure monitoring] and have recorded 47.706 serious issues needing a referral of these patients to a physician and, in some cases, even to the emergency units of a hospital.

These data confirm the great value provided by Italian community pharmacies both in monitoring the issue of cardiovascular disease in all our national territory and providing a concrete solution to the historical problem of long waiting list of our National Health Service.

Moreover, as the doctor remains responsible for exam reporting and evaluation – while the pharmacist is responsible for the proper installation and maintenance of the devices used – telemedicine service represents actually a very good example of a real partnership between health professionals concretely involved in primary care services in the patients’ interest.

Netherlands: multidisciplinary initiatives led by pharmacists to improve care for patients with chronic heart failure

In the Netherlands, the COHESION consortium (COHESION: Enhancing Pharmaceutical Care in Chronic Heart Failure), funded by the KNMP research grant for 2024-2029, is a multidisciplinary initiative aimed at improving care for patients with chronic heart failure (CHF). The project emphasizes the role of pharmacists, both in community and hospital settings, in coordinating and delivering personalized pharmaceutical care.

The objectives of this project are to develop a tailored pharmaceutical care program for CHF patients; reduce hospital admissions due to acute heart failure episodes; and strengthen collaboration among pharmacists, cardiologists, general practitioners, nurses, and patients.

Community pharmacists are central to the COHESION approach. They contribute by ensuring medication adherence and safety; monitoring therapy effectiveness; adjusting treatments in collaboration with other healthcare professionals; and supporting patients in managing their condition through education and follow-up.

The consortium undertakes literature reviews to identify barriers and facilitators in CHF treatment; stakeholder analyses to understand the needs of patients, providers, insurers, and policymakers; development and testing of pharmaceutical care interventions; evaluation of clinical outcomes and cost-effectiveness; and implementation studies to support broader adoption.

More information on this project is available in https://www.knmp.nl/beroepsontwikkeling/onderzoek/cohesion.

Portugal: Community pharmacies provide structured hypertension management programs, combining blood pressure monitoring with adherence support and lifestyle counselling.

Community pharmacies in Portugal provide a broad spectrum of healthcare services that play a key role in the prevention and management of cardiovascular diseases. Pharmacists routinely perform blood pressure, blood glucose, and lipid profile measurements, as well as cardiovascular risk assessments using validated tools such as SCORE2 and SCORE2-OP, enabling early identification of individuals at increased risk.

Pharmacy services also include smoking cessation consultations, structured medication reviews, and individualized medication preparation (dose administration aids), which contribute to safer and more effective long-term pharmacotherapy.

In addition, Portuguese community pharmacists actively promote health literacy and patient empowerment, supporting individuals in understanding their therapy, adopting healthier lifestyles, and improving self-management of their cardiovascular health. This holistic and patient-centered approach reinforces continuity of care and enhances population health outcomes.

Spain: Spanish community pharmacies play a central role in the prevention and management of cardiovascular diseases.

Spanish community pharmacies provide a wide range of services related to the prevention and management of cardiovascular diseases. Regarding the use of medicines, they offer the therapeutic adherence service and the medication repackaging service using personalized dosage systems. In addition, community pharmacies provide various public health services, such as clinical parameter measurement and disease screenings. Some pharmacies are also equipped with semi-automatic defibrillators to respond to emergencies.

Pharmacists provide a wide range of clinical professional pharmacy services to patients with different pathologies, but in most cases, these services are delivered to individuals at risk of cardiovascular disease or already diagnosed with it.

• Therapeutic adherence: helps patients take their medication correctly and consistently, which is crucial for controlling blood pressure, cholesterol, and other cardiovascular risk factors, reducing complications and hospitalizations.


• Medication repackaging using personalized dosage systems: organizes medicines according to the prescribed regimen, facilitating safe and accurate administration for patients with complex cardiovascular treatments and polypharmacy.


• Clinical parameter measurement: monitoring blood pressure, glucose, lipid profile, and weight allow early detection of cardiovascular risk factors and timely interventions.


• Semi-automatic defibrillators: some pharmacies are equipped to respond immediately to cardiac arrests, increasing survival rate and reinforcing their role as cardiac protected centers.


• Education and health promotion programs: pharmacists provide guidance on lifestyle, diet, and exercise to reduce cardiovascular risk and support chronic disease management, as well as lead initiatives to raise awareness about cardiovascular disease prevention within the community.


• Support for comorbidities: assistance for patients with multiple chronic conditions that influence cardiovascular health, ensuring comprehensive and coordinated care. This includes the early detection of conditions such as diabetes, atrial fibrillation, chronic kidney disease, dyslipidemia, colorectal cancer, or HIV, enabling preventive measures and timely referral to specialized care. For example, pharmacists contribute to stroke prevention through the early detection of atrial fibrillation by screening for irregular pulse in the general population.


• Coordination with healthcare providers: collaboration with physicians and other healthcare professionals to optimize patient care, follow-up, and treatment outcomes.

Spanish community pharmacies play a crucial role in the management and prevention of cardiovascular and other chronic diseases. Through the provision of comprehensive health services, including risk detection, disease screening, treatment adherence support, and health education, which enhance clinical outcomes and promote patient-centered care. Their widespread accessibility and implementation of cardioprotective measures reinforce their role as essential health establishments for cardiovascular health in the community.