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Aged-care

Research team

Professor Andrew McLachlan, Professor of Pharmacy, Aged Care (Concord Hospital)
Dr Tim Chen, Senior Lecturer, Pharmacy Practice
Dr Beata Bajorek, Lecturer, Pharmacy Practice

Research summary

Many patients in an ageing population are taking complex medication regimens, and medication adherence and the quality use of medicines are important aspects of their management. Research at Sydney is exploring the impact of pharmacist-conducted residential medication management reviews on psychotropic drug use in nursing homes. Psychotropic medicines contribute considerably to overall drug burden, producing significant adverse effects and are thought to be responsible for many falls in the elderly.

Research projects

  • Clinical Pharmacy and drug development
    This clinical pharmacology research project is investigating the contribution of ethnic differences to inter-individual variation in drug response. Determinants of ethnic differences in drug pharmacokinetics and pharmacodynamics, such as pharmacogenetic variation, will be investigated. In particular, this study is looking at the role and possible interactions with drug transporters involved in drug disposition and action.
  • A Drug Burden Index: Improving prescribing and function in older people
    This project tests the DBI as a tool to improve the quality use of medicines in older Australians. The study will improve the evidence base for the association between overall medication exposure and function in older people. The HMR model is a sustainable government funded service that can be used to bring this research finding into practice if it is found to benefit older Australians. We hypothesise that the DBI represents a clinically useful tool to guide prescribing for older adults. Use of DBI as a risk assessment measure may help prescribers optimise physical and mental function, independence and quality of life in their older patients. This Application will test the DBI as part of pharmacist-led HMR to systematically guide prescribing in older people.

Competitive research grants

  • "Pain control in older people"
    McLachlan, Naganathan, Le Couteur, Hilmer & Gibson
    NHMRC Project Grant # 571054
    $393,750
    2009 - 2011
  • "The role of community pharmacy in post hospital management of patients initiated on warfarin"
    Peterson, Jackson, Bereznicki, McLachlan, Bajorek, Angley, Mullan Gaetani, Misan & Nelson
    Pharmacy Guild of Australia
    $1,128,777
    2007 - 2009
  • "Pharmacy-based model enabling patient self-monitoring of warfarin: Development and evaluation"
    Bereznicki, Peterson, Jackson, McLachlan, Bajorek, Nelson, Mqrsden, Gee, Fitzmaurice
    Pharmacy Guild of Australia
    $198,603
    2007 - 2009
  • "The first placebo-controlled trial of paracetamol for back pain"
    Latimer, Maher, McLachlan, Cooper, Hancock
    NHMRC Project Grant # 570883
    $602,625
    2009 - 2011
  • "Inter-ethnic differences in tolerance of anti-cancer drugs"
    Clarke, McLachlan
    NHMRC Project Grant # 512533
    $332,125
    2008 - 2010

HDR candidates

  • Nistala, Shiva P.
    Doctor of Philosophy (full-time)
    Submit: February 2011
    "Psychotrophic medicines in older people: Impact of medication reviews"
    Primary Supervisor: Dr Tim Chen
    Associate Supervisor: Professor Andrew McLachlan
  • Perera, Vidya
    Doctor of Philisophy (full-time)
    Submit: February 2012
    "Investigation of inter-ethnic differences in CYP1A2"
    Primary supervisor: Professor Andrew McLachlan
    Associate supervisor: Dr Tim Chen
  • Stocker, Sophie L.
    Doctor of Philosophy (full-time)
    Submit: February 2010
    "Quality use of urate lowering medicines"
    Primary supervisor: Professor Andrew McLachlan
    Associate supervisor: Williams
  • Basger, Benjamin J.
    Doctor of Philosophy (part-time)
    Submit: July 2014
    "Inappropriate drug use in elderly Australians"
    Primary supervisor: Dr Tim Chen
    Associate supervisor: Dr Rebekah Moles
  • Sayeed, Naser
    Doctor of Philosophy (full-time)
    Submit: February 2013
    "Information needs and wants of elderly patients on warfarin therapy: The role and utility of web-based resources"
    Primary supervisor: Dr Beata Bajorek
    Associate supervisor: Mullen

Recent publications

  1. Castelino RL, Bajorek BV, Chen TF (2009). Targeting Inappropriate Prescribing in the Elderly: A Review of the Impact of Pharmacy Services, Annals of Pharmacotherapy, Volume 43, June.
  2. Bajorek BV, Ogle SJ, Duguid MJ, Shenfield GM, Krass I (2009). Balancing risk versus benefit: The elderly patient’s perspective on warfarin therapy, Pharmacy Practice, 7:2, 113-123, June.
  3. Bajorek BV, Yau L, Lee K, Zulueta W (2009). Management of over-anticoagulation in warfarinised hospital patients, Journal of Pharmacy Practice and Research, 39:1, 13-18.
  4. McLachlan AJ, Hilmer SN, Le Couteur DG (2009). Variability in response to medicines in older people – phenotypic and genotypic factors, Clin Pharmacol Ther, 85(4):431-3.
  5. Hilmer S, Perera V, Mitchell S, Dent J, Murnion B, Bajorek BV, Matthews S, Rolfson D (2009). The assessment of frailty in older people in acute care, Australasian Journal on Ageing, DOI: 10.1111/j.1741-6612.2009.00367.x, In press, July 2009
  6. N. Nguyen, B.Bajorek (2008). Pharmacist prescribing in warfarin therapy: Exploring its clinical utility in the hospital setting, Journal of Pharmacy Practice and Research, 38(1): 35-39.
  7. Basger BJ, Chen TF, Moles RJ (2008). Inappropriate medication use and prescribing indicators in the Australian elderly, Drugs and Aging, 25(9):777-793.
  8. Nishtala P, McLachlan A, Bell S, Chen TF (2008). Psychotropic prescribing in long-term care facilities: Impact of medication reviews and educational interventions, American Journal of Geriatric Psychiatry, 16(8): 621-632.
  9. Su EY, Naganathan V, Fallah H, Bajorek BV , McLachlan AJ (2008). Anticoagulation control in hospitalized patients on Warfarin, Journal of Pharmacy Practice and Research, 38(4): 292-295.
  10. Glover S, Bajorek BV (2008). Exploring point-of-care testing of capillary blood in Warfarin management, Journal of Pharmacy Practice and Research, 38(4): 300-304.
  11. Dona S Buchan, BV Bajorek (2008). Incidence of Venous Thromboembolism and Thromboprophylaxis after Total Hip or Knee Arthroplasty, Journal of Pharmacy Practice and Research, Vol 38(3):200-204.
  12. Iyer S, Naganathan V, McLachlan A, Le Couteur DG (2008). Medication withdrawal trials in people older than 65 years: A systematic review, Drugs & Aging 25:1021-1031.