Ageing & Pharmacology

Researchers within the Laboratory of Ageing and Pharmacology are working to ensure older people receive the best possible health care and treatment advice. Our focus is on prevention and better management of common challenges like frailty, falls and confusion.

Our team is working to improve the safety and effectiveness of medicines for older adults. We use laboratory, clinical and population based studies to understand the risks and benefits of medicines in older people, particularly those with multiple chronic medical conditions. These findings help older people benefit from medicines and minimise adverse effects.

We have developed a pharmacological risk assessment tool, the Drug Burden Index, to assess the impact of an older person’s medicines on their physical function. We have demonstrated that a higher Drug Burden Index is linked to loss of independence, more falls, frailty, longer stays in hospital and a greater mortality.

We are now developing software, the Drug Burden Index Calculator©, which we are using to trial the Drug Burden Index in clinical practice. It is clinical tool to help stop medicines that are likely to cause more harm than benefit. We have taken a new approach to better understand how multiple medicines impair physical and cognitive function in old age, and that approach is now being incorporated into practice in hospitals, community and residential aged care settings in Australia and internationally.

A major theme of our research is investigating the effects of medicines when taken by frail, older people and those with dementia. We have developed tools to measure frailty in hospital patients and we have shown that frailty affects how medicines work and their overall effectiveness and safety.

We found that the use of multiple medicines at the same time and some particular types of medicines increase the risks of becoming frail and confused. We have developed tools to help doctors, nurses and pharmacists align medicines use with goals of care, and understand the attitudes of older people and their carers to stopping unnecessary medicines.

Our research group prioritises education, mentorship, capacity building, collaboration and policy work. Several of Professor Hilmer’s PhD graduates and post-doctoral researchers have been awarded NHMRC fellowships, while many other students have gone on to conduct national and international post-doctoral research or study medicine or pharmacy. International early and mid-career researchers in geriatric pharmacology frequently spend time in our laboratory. Several of our researchers visit the laboratories of our collaborators nationally and internationally at leading research institutes such as the National Institute on Aging, Baltimore, USA.

Our team is part of the Penney Ageing Research Unit, which conducts aged care research on the Royal North Shore Hospital campus.


Professor Sarah Hilmer Professor Sarah Hilmer BScMed(Hons) MBBS(Hons) FRACP PhD

Conjoint Professor of Geriatric Pharmacology
Medicine, Northern Clinical School

Dr John Mach

Postdoctoral Research Fellow

Dr Lisa Kouladian-O’Donnell

Postdoctoral Research Fellow

Dr Nashwa Masnoon

Postdoctoral Research Fellow

Dr Kenji Fujita

Postdoctoral Research Fellow

Dr Seung Jae Kim

Postdoctoral Research Fellow

Associate Professor Susan Ogle - Clinical academic

Dr Constance Vogler - Clinical academic

Dr James Hardy - Clinical academic

Dr Helen Wu - Clinical academic

Dr Kevin Chang - Clinical academic

Sarita Lo - Research Pharmacist

Maureen Bartels - Administration officer

Dr Trang Tran - PhD Student

Gizem Gemikonakli - PhD Student

Dr Harry Wu - PhD Student

Mai Duong - PhD Student

Dr Brendan Ng - MPhil Student

Patrick Sutton - MD Student

Jannessa Yao - Honours Student

NSLHD: Rehabilitation and Aged Care; University of Sydney: NHMRC Cognitive Decline Partnership Centre, Charles Perkins Centre Healthy Ageing Node

Basic science

  • Understanding the effects of polypharmacy, Drug Burden Index and deprescribing in ageing

Clinical trials

  • Goal-directed Medication review Electronic Decision Support System (G-MEDSS)
  • Opti-Med: A randomised controlled trial of deprescribing to optimise health outcomes for frail older people
  • Reducing Medication Complexity (SIMPLER study)

Implementation studies

  • Reduce inappropriate polypharmacy in hospital: development and evaluation of resources including educational module, guidelines for clinicians and consumers, quality indicators and use of Drug Burden Index as a clinical risk assessment tool
  • Deprescribing guidelines for clinicians and consumers

Population studies

  • Pharmacoepidemiology: association between drug use and global health outcomes in older people nationally and internationally

Policy

  • Recommendations for a National Strategic Action Plan to Reduce Inappropriate Polypharmacy: development and implementation

Events, News and Seminars

Researchers tackle one of the nation’s biggest health challenges

Researchers tackle one of the nation’s biggest health challenges

Researchers from the Kolling Institute will support an important, Australia-wide project to address ..... Read more

Category: Neuroscience and Pain Research, Research Excellence

Research to inform new guidelines on the safe use of medicines

Research to inform new guidelines on the safe use of medicines

Two Royal North Shore Hospital clinician researchers will play a key role in a national research pro..... Read more

Category: Funding support, Research Excellence

Age and sex influence the adverse effects of multiple medications

Age and sex influence the adverse effects of multiple medications

There are calls for a carefully-considered, tailored approach to the prescription of multiple medici..... Read more

Category: Neuroscience and Pain Research, New Treatment