Clinical Pharmacokinetics - Optimisation of drug dosage - e.g. Allopurinol & Febuxostat (gout), Metformin (antidiabetic), Anti-infectives e.g. Gentamicin & Vancomycin (antibiotics) and Ribavirin

    •    Background:


- There is often a better correlation between patient responses to a drug and  measured drug plasma concentrations than the administered drug dose.

- Many drugs have highly variable pharmacokinetics (plasma concentrations)
.

- Optimising drug dosage according to pharmacokinetics is the key to optimising drug effectiveness. 


•    Methods:


- Clinical: Patient recruitment, blood collections
.

- Analytical: Chromatography (HPLC), DNA extraction and genetic analysis (SNPs)


- Data analysis: Computerised PK modelling, simulations and optimising dosing, correlations with patient response 


Decision support – Can we help doctors make better prescribing decisions? 


    •    Background:


- Medication management in Australian hospitals is shifting from paper to electronic formats, with many hospitals now using electronic prescribing systems 


- These systems often include computerised alerts, which trigger at the point of prescribing to warn doctors about potential errors in orders 


- Computerised alerts can help doctors make better prescribing decisions but getting this ‘decision support’ right is tricky 


•    Research: 


     Qualitative methods (e.g. interviewing doctors) combined with quantitative methods (e.g. review of medication charts and alerts) to:

- Evaluate the current decision support at St Vincent’s Hospital – is it working?


- Understand what doctors want and need to be better prescribers – how can we help?

- Test new ways of helping doctors prescribe – what works and what doesn’t? 


Can outcomes for gout sufferers be improved with eHealth?

    •    Background:


    - Gout is the most common form of inflammatory arthritis. It is characterised by extreme pain and swelling and is caused by a build up of uric acid in the bloodstream.

    - Gout can be successfully managed by drug therapy. However, the prevalence of gout is increasing.

    - A novel IT intervention (a mobile phone app) to support gout management in the community could enhance outcomes for gout sufferers. 


    •    Research:

    - Qualitative methods (e.g. interviewing doctors and gout patients) to:

    - Understand usability of IT interventions – are patients happy to use an app to manage their condition? Would “gamification” improve user uptake?

    - Designing effective educational materials for GPs on gout.

    - Interviewing gout patients about their treatment satisfaction.

    - Understanding how gout patients with comorbidities view gout in relation to their other conditions.

Effect of Paracetamol on myeloperoxidase 


    •    Background:


- Paracetamol - major analgesic drug
.

- Myeloperoxidase - enzyme of neutrophils.


- Myeloperoxidase produces HOCl - tissue oxidant
.

- Myeloperoxidase present in atherosclerotic lesions
.

- Paracetamol is substrate and inhibitor of myeloperoxidase
.

- Paracetamol may decrease atherosclerosis
.

- Interactions of paracetamol analogues with myeloperoxidase? 


•    Methods:


- Analytical: Enzyme assay, Chromatography (HPLC), UV spectroscopy, Nuclear magnetic resonance spectroscopy

    - Statistical analysis 

A critical look at drug development 


    •    Background: 

    - Increasing prices for cancer medicines challenge our ability to pay for them.

    - Payers are being challenged to develop news ways for assessing the value of innovative cancer medicines.

    - There is little agreement about how much these drugs are really worth, and how governments should respond.  

    •    Outline of Project: 

    - Summarising critical information about cancer medicines subsidised, or denied subsidisation, by the Pharmaceutical Benefits Scheme.

    •    Focus: 

    - Cancer.

    -  Access to medicines.

    - Affordability/Reimbursement.

    - Equity.

    - Influences on the R&D and drug development agenda.

    - Pharmaceutical policy.