Development and validation of a logic model for comprehensive medication management services Samuel R.A. e Sousa a , Sarah Joyce Shoemaker b , Mariana M.G. do Nascimento a , Marianne S. Costa a and Djenane Ramalho de Oliveira a a School of Pharmacy, Federal University of Minas Gerais (FAFAR/UFMG), Belo Horizonte, Minas Gerais, Brazil and b Abt Associates, Cambridge, MA, USA Keywords comprehensive medication management; Delphi method; logic model; medication therapy management; pharmaceutical care Correspondence Samuel R.A. e Sousa, School of Pharmacy, Federal University of Minas Gerais (FAFAR/ UFMG), Av. Ant^ onio Carlos, 6627, Campus Pampulha, CEP 31270-901 - Belo Horizonte, Minas Gerais, Brazil. E-mail: samuel.ralmeida@gmail.com Received January 10, 2017 Accepted July 4, 2017 doi: 10.1111/ijpp.12392 Abstract Objectives To develop and validate a theoretical logic model for comprehen- sive medication management (CMM) services. Methods The components of a logic model were constructed after a literature review and interviews with 4 CMM professionals. To validate the logic model, a panel of 17 CMM experts participated in three online Delphi method rounds to achieve consensus on the model. The consensus between the experts on each component of the logic model was evaluated using the Content Validity Index and Inter-rater Agreement in each of the rounds. Key findings A logic model for CMM services containing 51 items was con- structed and validated. Both the items of each component of the model and the linkage between the main components were agreed upon among the experts. Conclusions A logic model for CMM services was developed and validated. It is an innovative tool that, if used as a theoretical framework for the implemen- tation of CMM, can ensure greater reproducibility of CMM services in different scenarios of practice and levels of care. Introduction Adverse drug reactions represent approximately 4.6% of European hospital admissions [1] and 0.5% of ambulatory visits in the USA. [2] However, the impact of drug-related morbidity and mortality is thought to be even higher as there are other drug therapy problems (DTPs) that can cause harm to the patient like the use of unnecessary or ineffective medications, the use of high dosages and non- adherence. [3–7] Comprehensive medication management (CMM) is a service that uses the theoretical framework of pharmaceu- tical care practice, which has the main goal of optimizing patient’s pharmacotherapy and resolving DTPs. [8,9] This service has shown effectiveness in reducing drug-related morbidity and mortality. [10–16] In a CMM consultation, a pharmacist performs a comprehensive assessment of all the patient’s medications for identification and resolution of DTPs, builds a care plan to resolve the identified prob- lems, and follows up with the patient to assess the actual outcomes of drug therapy. [8,9] The provision of CMM services involves a continuous patient care process to promote optimal outcomes. This care process, together with the philosophy of practice and the practice management system, represents the three structural components of CMM that make the service reproducible in any healthcare setting. [8,9] Several authors have described the implementation of CMM services. [17–24] However, to our knowledge, no study has presented a theoretical structure that can serve as a guide for planning and implementing CMM in dif- ferent healthcare settings. The theoretical structure of a service can be represented by a logic model which is a graphical representation that presents all the essential components of a service. The logic model can improve the planning of the service and reduce the adaptation time needed from initial implemen- tation to sustained, proper operation. [25] There are three different types of logic models: the conceptual approach model, the outcome approach model and the activities © 2017 Royal Pharmaceutical Society International Journal of Pharmacy Practice 2017, , pp. – International Journal of Pharmacy Practice Research Paper International Journal of Pharmacy Practice 2017, , pp. –