Research Areas
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.
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