Ageing and 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.

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Projects

Publications

Professor Sarah Hilmer 

Professor Sarah Hilmer 

Head, Ageing and Pharmacology Laboratory
Head of Department of Clinical Pharmacology, Royal North Shore Hospital
Conjoint Professor of Geriatric Pharmacology, The University of Sydney

Dr John Mach

Senior Research Fellow
Laboratory Manager (Basic Science Branch), The University of Sydney

Dr Lisa Kouladian-O’Donnell

Senior Lecturer
Faculty of Medicine and Health, The University of Sydney

Associate Professor Susan Ogle

Senior Staff Specialist, Department of Aged Care, Royal North Shore Hospital
Clinical Associate Professor, The University of Sydney

Dr Nashwa Masnoon

Dr Nashwa Masnoon

Postdoctoral Research Fellow
Faculty of Medicine and Health, The University of Sydney

Kevin Winardi

Scientific Officer, Northern Sydney Local Health District

Dr Kenji Fujita

Research Fellow
Faculty of Medicine and Health, The University of Sydney

Dr Edwin Tan 

Associate Professor Edwin Tan 

Sydney Pharmacy School, The University of Sydney

Dr. Bonnie Liu

Staff Specialist Geriatrician, Royal North Shore Hospital
Clinical Lecturer, The University of Sydney

Dr Connie Vogler

Program Manager, Sydney Health Partners
Geriatric Medicine, Clinical Academic Group, The University of Sydney

Dr Noriko Sato

Research Fellow
School of Pharmacy, The University of Sydney

Maureen Bartels

Secretary, Department of Clinical Pharmacology, Royal North Shore Hospital

Dr James Hardy

Clinical Senior Lecturer, The University of Sydney
Head of Department and Senior Staff Specialist, Department of Aged Care, Royal North Shore Hospital

Dr Helen Wu

Senior Lecturer
Senior Staff Specialist, Department of Aged Care, Royal North Shore Hospital

Dr Arpita Das

Research Program Manager, Frailty Measurement
The University of Sydney

Dr Kevin Chang

Clinical Senior Lecturer, The University of Sydney
Senior Staff Specialist, Department of Aged Care, Royal North Shore Hospital

Sarita Lo

Research Pharmacist, Northern Sydney Local Health District

Christine Lu

Professor (USyd Chair of Clinical Pharmancy)

Bridin Murnion

Clinical Associate Professor, The University of Sydney
Senior Staff Specialist, Clinical Pharmacology, Northern Sydney Local Health District

Nina Pham

Research Fellow (Pharmacy Practitioner)

Leping (Victor) Kong

PhD Student

Shumin Tan

Research Assistant, The University of Sydney

Josie Hughes

Research Assistant, The University of Sydney

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

Musculoskeletal Research

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