Medication Safety
Safe and appropriate medication prescribing of older patients with chronic obstructive pulmonary disease (COPD) - also offered as MBiomedSc
Supervisors: Professor Elizabeth Manias, Dr Snezana Kusljic and Ms Alexandra Gorelik
Project Site: Royal Melbourne Hospital, Parkville Campus; Melbourne School of Health Sciences
Contact: Professor Elizabeth Manias T: 0450 308 060 E: emanias@unimelb.edu.au
Project description: Chronic obstructive pulmonary disease (COPD) is a progressive and disabling condition that leads to chronic and recurrent airflow obstruction. COPD is an umbrella term used for two pathological lung conditions: chronic bronchitis and emphysema. According to national figures, COPD affects 5.7% of older Australians aged 55 and over, with the main cause being active smoking although some people with COPD have never smoked. The mainstay of therapy includes administration of bronchodilators and corticosteroids. Furthermore, older individuals in general have a number of other co-morbidities, such as diabetes and hypertension for which they require regular medications. The use of multiple medications in older patients to treat a range of conditions adds to the complexity of their medication regimen and also increases the burden of care and cost of treatment.
In this study, the STOPP (Screening Tool of Older Persons' Prescriptions) and START (Screening Tool to Alert doctors to Right Treatment) criteria will be applied to a random sample of older patients admitted to hospital for an exacerbation of COPD. Use of these screening tools will determine what medications have been inappropriately commenced in older patients and what medications have been inappropriately stopped or not commenced in older patients. The adverse events experienced by older patients will also be examined to determine whether the medications they are prescribed may be associated with these adverse events. Medical histories of older patients will be examined retrospectively on admission, at two days following admission and at discharge. Following completion of the study, recommendations will be made about the safety and appropriateness of medication prescribing for older patients with COPD.
Safe and appropriate medication prescribing of older patients with dementia – also offered as MBiomedSc
Supervisors: Professor Elizabeth Manias, Dr Snezana Kusljic and Ms Alexandra Gorelik
Project Site: Royal Melbourne Hospital, Parkville Campus; Melbourne School of Health Sciences,
Contact: Professor Elizabeth Manias T: 0450 308 060 E: emanias@unimelb.edu.au
Project description: With increasing aging of the Australian population, the proportion of older patients with dementia is expected to increase markedly over time. About one in ten patients aged over 65 years and about three in ten patients over the age of 85 years have dementia. Dementia is a leading cause of death in older patients, and it is associated with increased burden of care, and prolonged illness and disability. Many older patients with dementia also have a number of other chronic conditions, such as depression, osteoarthritis, and diabetes, which escalates the complexity of their medication regimen.
In this study, the STOPP (Screening Tool of Older Persons' Prescriptions) and START (Screening Tool to Alert doctors to Right Treatment) criteria will be applied to a random sample of older people with dementia admitted to hospital for treatment of an acute condition. Use of these screening tools will determine what medications have been inappropriately commenced in older patients with dementia and what medications have been inappropriately stopped or not commenced in these patients. The adverse events experienced by older patients with dementia will also be examined to determine whether the medications they are prescribed may be associated with these adverse events. Medical histories of older patients will be examined retrospectively on admission, at three days following admission and at discharge. Following completion of the study recommendations will be made about the safety and appropriateness of medication prescribing for older people with dementia in hospitals.