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.


Lead

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

Professor Sarah Hilmer and her team were nominated for a 2019 NSW Health Award for their project reviewing medication in older people.

Post-doctoral Researchers:

Dr John Mach Dr John Mach BSc(Hons) PhD

A major theme of our research is investigating the effects of medicines with frail, older people. With the support of the NHMRC Cognitive

Dr Lisa Kouladjian-ODonnell Dr Lisa Kouladian-O’Donnell BMedSci(Hons) MPharm PhD

Dr Mouna Sawan Dr Mouna Sawan B.Pharm, PhD, AACP

Research Affiliates:

Dr Danijela Gnjidic Dr Danijela Gnjidic BSc (Hons) PhD MPH; NHMRC Dementia Leadership Fellow

Dr Emily Reeve Dr Emily Reeve BPharm (Hons) PhD; NHMRC-ARC Dementia Research Development Fellow

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 guide better use of medicines

Researchers guide better use of medicines

With the majority of older Australians taking five or more medications, a team from the Kolling Inst..... Read more

Category: Research Excellence

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New medication may offer long-acting relief for those with knee osteoarthritis

A study has been launched to investigate the benefits of a new injectable medication for those with..... Read more

Category: New Treatment

Researchers assess new approach to post-operative care

Researchers assess new approach to post-operative care

With increasing evidence around the benefits of physiotherapy after surgery, a project is set to get..... Read more

Category: New Treatment