Drugs & Aging

, Volume 31, Issue 11, pp 825–835 | Cite as

Impact of the Pharmacist Medication Review Services on Drug-Related Problems and Potentially Inappropriate Prescribing of Renally Cleared Medications in Residents of Aged Care Facilities

  • Pankti A. GheewalaEmail author
  • Gregory M. Peterson
  • Colin M. Curtain
  • Prasad S. Nishtala
  • Paul J. Hannan
  • Ronald L. Castelino
Original Research Article



Drug-related problems (DRPs) are common in aged care facilities and few studies have been conducted to determine the impact of the pharmacist-conducted medication review services. Studies determining the prevalence of chronic kidney disease (CKD) and data regarding inappropriate prescribing of renally cleared medications in aged care facilities in Australia are also lacking.


To investigate the number and nature of DRPs identified and recommendations made by pharmacists in residents of aged care facilities. To determine the prevalence of CKD and estimate the magnitude of inappropriate prescribing of renally cleared medications in residents of aged care facilities.


DRPs identified and recommendations made by pharmacists were classified using the adapted version of the DOCUMENT classification system. The modification of diet in renal disease formula was used to estimate the prevalence of CKD, and the Cockcroft–Gault formula was used to estimate the magnitude of inappropriate prescribing of renally cleared medications.


Over 98 % of residents of aged care facilities had at least one DRP. Most (83.8 %) recommendations made by accredited pharmacists to resolve DRPs were accepted by general practitioners. CKD was prevalent in 48 % of residents, and inappropriate prescribing of renally cleared medications was identified in 28 (16 %) residents with CKD.


DRPs are common in aged care facilities and the impact of medication review services appears to be high. CKD is also common among residents of aged care facilities, and inappropriate prescribing of renally cleared medications was also prevalent, warranting attention to regular renal function monitoring and appropriate drug and dose selection in residents of aged care facilities.


Chronic Kidney Disease Glomerular Filtration Rate Inappropriate Prescribe Potentially Inappropriate Prescribe Aged Care Facility 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



Pankti Gheewala, Gregory Peterson, Colin Curtain, Prasad Nishtala, Paul Hannan and Ronald Castelino have no potential conflicts of interests that are directly relevant to the content of this study. No sources of funding were used to assist in this study. Paul J. Hannan is a consultant for Meditrax Pty Ltd. The authors acknowledge Meditrax Pty Ltd and staff for providing de-identified medication reviews used in this study.

Supplementary material

40266_2014_208_MOESM1_ESM.docx (30 kb)
Supplementary material 1 (DOCX 30 kb)


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Copyright information

© Springer International Publishing Switzerland 2014

Authors and Affiliations

  • Pankti A. Gheewala
    • 1
    Email author
  • Gregory M. Peterson
    • 1
  • Colin M. Curtain
    • 1
  • Prasad S. Nishtala
    • 2
  • Paul J. Hannan
    • 3
  • Ronald L. Castelino
    • 1
  1. 1.School of MedicineUniversity of TasmaniaHobartAustralia
  2. 2.School of PharmacyUniversity of OtagoDunedinNew Zealand
  3. 3.MeditraxSydneyAustralia

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