A5010094499- Pharmaceutical Practices and Patient Outcomes
- Health Systems, Economic Evaluations, Quality of Life
- Patient Safety and Medication Errors
- Frailty in Older Adults
- Nutrition and Health in Aging
- Electronic Health Records Systems
- Pharmacovigilance and Adverse Drug Reactions
- Patient-Provider Communication in Healthcare
- Cardiac, Anesthesia and Surgical Outcomes
- Geriatric Care and Nursing Homes
- Blood Pressure and Hypertension Studies
- Intensive Care Unit Cognitive Disorders
- Mobile Health and mHealth Applications
- Healthcare innovation and challenges
- Palliative Care and End-of-Life Issues
- Artificial Intelligence in Healthcare and Education
- Quality and Safety in Healthcare
- Healthcare Systems and Technology
- Medication Adherence and Compliance
- Pharmaceutical studies and practices
- Innovations in Medical Education
- Schizophrenia research and treatment
- Digital Mental Health Interventions
- Healthcare cost, quality, practices
- Chronic Disease Management Strategies
The University of Sydney
2020-2025
Northern Sydney Local Health District
2023-2025
Royal North Shore Hospital
2019-2024
Concord Repatriation General Hospital
2021-2024
Medication review is integral in the pharmacological management of older inpatients. To assess association in-hospital medication changes with 28-day postdischarge clinical outcomes. Retrospective cohort 2000 inpatients aged ≥75 years. included number increases (medications started or dose-increased) and decreases stopped dose-decreased) for (i) all medications, (ii) Drug Burden Index (DBI)-contributing medications (iii) Beers Criteria 2015 (potentially inappropriate PIMs). Changes also...
The drug burden index (DBI) measures a person's total exposure to anticholinergic and sedative medications, which are commonly associated with harm. Through incorporating the DBI in electronic medical records (eMR) implementing stewardship program, we aimed determine (i) uptake of steward's recommendations deprescribe and/or drugs by team (ii) whether accepted were actioned hospital or recommended for follow-up General Practitioner post-discharge.
Comprehensively investigate prescribing in usual care of hospitalized older people with respect to polypharmacy; potentially inappropriate medications (PIMs) according Beers criteria; and cumulative anticholinergic sedative medication exposure calculated Drug Burden Index (DBI). Specifically, quantify these measures on admission, changes between admission discharge, associations adverse outcomes costs.Established new retrospective inpatient cohort 2000 adults aged ≥75 years, consecutively...
Implementation of the Drug Burden Index (DBI) as a risk assessment tool in clinical practice may facilitate deprescribing. The purpose this study is to evaluate how comprehensive intervention bundle using DBI impacts (i) proportion older inpatients with at least one DBI-contributing medication stopped or dose reduced on discharge, compared admission; and (ii) changes deprescribing different classes during hospitalisation. This before-and-after was conducted an Australian metropolitan...
To inform the design of electronic decision support (EDS) to facilitate deprescribing in hospitals we set out (1) explore current processes in-hospital medicines review, and communication decisions with patient's general practitioner (GP), (2) identify barriers undertaking these tasks (3) determine user preferences for EDS.Multimethod, multisite study comprising observations, semistructured interviews focus groups.General medicine, geriatric medicine rehabilitation wards at six two local...
Older inpatients with dementia are at an increased risk of adverse drug reaction (ADR) during hospitalization.
Patient-centred instructions on discharge can improve adherence and outcomes. Using GPT-3.5 to generate patient-centred instructions, we evaluated responses for safety, accuracy language simplification. When tested 100 summaries from MIMIC-IV, potentially harmful safety issues attributable the AI tool were found in 18%, including 6% with hallucinations 3% new medications. tools but careful implementation is needed avoid harms.
Abstract Objective(s) To develop and validate a frailty index (FI) that covers multiple domains, using routine hospital data. investigate the FI's validity, after excluding medication‐related items (FI‐ExMeds), for studies of polypharmacy. Methods A FI was derived from NSW data following standard published guidance. In development cohort (151 inpatients ≥ 70 years), correlated with Reported Edmonton Frail Scale (REFS) Pearson's R . Validity distribution FI‐ExMeds, correlation each other,...
Deprescribing, the supervised withdrawal of inappropriate medications, intends to manage polypharmacy, which is prevalent in older patients.To examine general practitioner (GP) perceptions communication processes between clinicians hospital and GP community about deprescribing decisions made hospital.Focus groups interviews were held with 15 GP, exploring hospitals, information format communications. Sessions audiotaped, transcribed analysed using an inductive approach.GP stated that they...
Abstract Background Frailty is an important determinant of health‐care needs and outcomes for people in hospital. Objectives To compare characteristics predictive ability a multidomain frailty index derived from routine health data (electronic index‐acute hospital; eFI‐AH) with the hospital risk score (HFRS). Methods This retrospective study included 6771 patients aged ≥75 years admitted to Australian metropolitan tertiary referral between October 2019 September 2020. The eFI‐AH HFRS were...
In this case study we describe how Sydney Local Health District (SLHD) Disability Inclusion and Advice Service (DIAS) provided support to disability group homes during the COVID-19 Delta Omicron waves. The provides insights into home providers’ experience of supports implemented by SLHD other stakeholders. A mixed method approach was undertaken that included analysing data from a database electronic medical records survey managers. DIAS developed range processes prevention, outbreak...
The Drug Burden Index (DBI) measures exposure to anticholinergic and sedative drugs, which are associated with harm in older adults. To facilitate deprescribing Australian inpatients, we piloted an intervention bundle integrating the DBI Electronic Medical Records, clinician guides, consumer information leaflets a stewardship pharmacist.