The CardioPgX-TWIN project aims to enable the routine use of pharmacogenomics in cardiovascular medicine by transferring a mature, clinically proven personalised prescribing system from Spain to Lithuania. Its main objective is to build the capacity of the Lithuanian healthcare system to integrate genetic information into everyday cardiovascular treatment decisions, an area where pharmacogenomics is currently underutilised despite its high clinical relevance. The project focuses on implementing a structured framework that combines clinical workflows, governance models, and a clinical decision support system to guide drug and dose selection based on each patient’s genetic profile. By embedding these tools into routine clinical practice, it aims to improve treatment effectiveness, reduce adverse drug reactions, and make prescribing more precise and evidence-based. In addition, the project seeks to strengthen institutional capacity through training, multidisciplinary collaboration, and the development of standardised procedures and implementation roadmaps.