The aim of this study is to assess the impact of comprehensive medication management (CMM) services on clinical outcomes in older patients with chronic conditions in a nursing home, and to present the interventions aimed at improving therapeutic outcomes, as well as their acceptance by general practitioners (GPs) and patients. A prospective, interventional study was conducted from October 2023 to July 2024 at the Nursing Home Center. Participants included residents taking at least one medication or dietary supplement and having at least one chronic disease. The CMM services were provided by pharmacists, who, together with the GP and patient, established specific goals of therapy for each resident. A total of 56 patients participated, 87.5% of whom were women, with a median of 11 (1–20) medications used and 9 (1–24) comorbidities. 289 drug therapy problems (DTP) were identified, averaging 5.5 per patient. The most frequent DTPs were "Unnecessary drug therapy" (22.15%) and "Dosage too low" (19.72%). Overall 289 interventions were proposed, of which 90% were accepted by patients and 88.04% by GPs. The most common interventions were "Discontinue drug therapy" (27.68%) and "Increase dose" (13.49%). A statistically significant difference in the number of medications used between the first and final consultations was observed, with increased deprescribing in inpatient care residents (p=0.0019) and increased medication use in residential users (p=0.0014). The most frequently deprescribed drugs were tramadol/paracetamol, diazepam, and pantoprazole. For patients diagnosed with primary hypertension, there was an observed increase in the number of those who achieved the therapeutic goal for the blood pressure at the last consultation (33.33%) compared to the first consultation (26.67%). The results of this study indicate that providing CMM services and integrating a pharmacist into a multidisciplinary team with a general practitioner and a nurse in a nursing home can significantly impact clinical outcomes improvement and optimization of therapy for nursing home residents. This suggests the need to expand CMM services to other nursing homes to improve healthcare for the elderly.