OBJECTIVE: To provide reference for pharmacist-led chronic disease management in community. METHODS: Through summarizing 196 times of chronic disease management in community, referring to domestic and foreign community chronic disease management mode, breakpoints of pharmacist-led chronic disease management in community were investigated primarily. The effects of the mode were evaluated by conducting questionnaire survey among patients (5 points the highest points). RESULTS & CONCLUSIONS: The breakthrough points of pharmacist-led chronic disease management work include: personal medication record, medication reconciliation, medication therapy review & interference, classification management of patients with chronic diseases and pharmaceutical telecare. Results of questionnaire survey showed that the influence of above pharmaceutical care on patients included helping understand the drugs,taking medicine on time,reducing adverse drug reaction,establishing correct concept of medication and reducing medical costs,which got scores of (4.19±0.67),(3.90±0.71),(3.71±0.82),(4.06±0.51) and (3.21±0.90), respectively. For convenience of pharmaceutical care,pharmacist ability,pharmacists’attitude,symptom improvement and improvement of the quality of life, the patients gave scores of (3.94±0.70),(4.39±0.64),(4.17±0.76),(3.86±0.71) and (3.90±0.73), respectively. Pharmacists can play a positive role in the management of chronic diseases by carrying out pharmaceutical care through the above breakthrough points, and the patients have a positive attitude towards pharmaceutical care.