930 results match your criteria: "Centre for Medicine Use and Safety[Affiliation]"

Closing the evidence-practice gap in dementia: two new national guidelines.

Age Ageing

January 2025

Faculty of Medicine Nursing and Health Sciences, Peninsula Clinical School, National Centre for Healthy Ageing, Monash University, Ngarnga Centre, Frankston, VIC, Australia.

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Objective: To determine whether glucagon-like peptide 1 receptor agonists (GLP-1RAs) and sodium-glucose cotransporter 2 (SGLT-2) inhibitors, separately, compared with dipeptidyl peptidase 4 (DPP-4) inhibitors are associated with a reduced risk of cirrhosis and other adverse liver outcomes among patients with type 2 diabetes.

Research Design And Methods: With an active comparator, new-user approach, we conducted a cohort study using the U.K.

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Comparison of United States and Australian pharmacy student attitudes towards careers in geriatrics.

Curr Pharm Teach Learn

December 2024

Division of Practice Advancement and Clinical Education, Clinical Education, UNC Eshelman School of Pharmacy, 121 Karpen Hall, 1 University Heights, Asheville, NC 28804, United States; UNC School of Medicine and UNC Health Sciences at MAHEC, 123 Hendersonville Rd, Asheville, NC 28803, United States; Center for Healthy Aging, Mountain Area Health Education Center, 123 Hendersonville Rd, Asheville, NC 28803, United States. Electronic address:

Introduction: The population of older adults is expanding globally, but there remains a lack of healthcare professionals trained to meet growing care needs. The primary objective of this study was to compare the top three to four factors driving interest vs. lack of interest in geriatrics among pharmacy students in the United States (US) vs.

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Background: As the number of medications increases, the appropriateness of polypharmacy may become questionable due to the heightened risk of medication-related harm.

Objectives: (1) To investigate the relationship between the number of current medications used by older adults and three indicators of potentially inappropriate polypharmacy: (a) the mean number of potentially inappropriate medications (PIMs), (b) the average count of drug-drug interactions, and (c) the anticholinergic burden; (2) To characterize the population-based burden of potentially inappropriate polypharmacy by calculating the proportion of individuals with these indicators.

Design: We conducted a population-based observational study using the Quebec Integrated Chronic Disease Surveillance System.

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Continuation of opioids at transitions of care increases the risk of long-term opioid use and related harm. To our knowledge, no study has examined the implementability of opioid deprescribing interventions at transitions of care. Our scoping review aimed to identify the type of opioid deprescribing interventions employed at transitions of care and assess the implementability of tested interventions.

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Background: Prevention of type 2 diabetes is becoming an urgent public health concern in low and middle-income countries (LMICs). However, there is currently no evidence of a cost-effective approach of health behaviour interventions from community settings in low-income countries like Nepal. Therefore, this study aimed to assess the within-trial economic evaluation of a health behaviour intervention compared with usual care for managing type 2 diabetes in a community setting in Nepal.

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Article Synopsis
  • Deprescribing is essential for older adults, focusing on safe medication management, and effective communication is critical in this process.
  • An international group of 14 experts created a framework to analyze how communication is utilized in deprescribing, identifying the need for more comprehensive approaches beyond just clinician-patient interactions.
  • The research highlights missed opportunities for enhancing deprescribing communication at the community level and calls for further studies to determine the most effective communication strategies and styles for this process.
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The productivity burden of breast cancer in Australia.

Cancer Epidemiol

February 2025

Health Economics and Policy Evaluation Research (HEPER), Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia; School of Public Health and Preventative Medicine, Monash University, Melbourne, Australia. Electronic address:

Purpose: Breast cancer exerts a considerable burden on an individual's health, but also impacts society more broadly through lost work productivity. This study aimed to measure the quality of life and productivity burden among Australian females of working age diagnosed with breast cancer in 2022.

Methods: A Markov lifetable model was simulated twice; the initial simulation followed the progression of Australian females diagnosed with breast cancer in 2022 using current population incidence rates, whilst the second simulation hypothetically assumed there were no females living with breast cancer.

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Background: Predicting metabolic drug-drug interactions (DDIs) via cytochrome P450 enzymes (CYP) is essential in drug development, but controversy has reemerged recently about whether in vitro-in vivo extrapolation (IVIVE) using static models can replace dynamic models for some regulatory filings and label recommendations.

Objective: The aim of this study was to determine if static and dynamic models are equivalent for the quantitative prediction of metabolic DDIs arising from competitive CYP inhibition.

Methods: Drug parameter spaces were varied to simulate 30,000 DDIs between hypothetical substrates and inhibitors of CYP3A4.

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Background: Given growing demand for hip and knee arthroplasty and unsustainable resource requirements, safe and efficient models of care are critical. This study aims to determine the impact on healthcare costs of implementing an enhanced short-stay model of care (ESS-MOC) for arthroplasty at a national level.

Methods: A budget impact analysis was conducted for the years 2023-2030 in the setting of Australian publicly and privately funded hospitals performing hip or knee arthroplasty.

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Background: Antimicrobial stewardship (AMS) guidelines now recommend antifungal stewardship (AFS) interventions to improve the management of invasive fungal diseases (IFDs). AFS programmes have not been reported in Australia.

Aims: To determine the monitoring of antifungal use, AFS strategies and targets, and barriers to AFS implementation in Australian hospitals.

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Immediate Versus 5-Year Risk-Guided Initiation of Treatment for Primary Prevention of Cardiovascular Disease for Australians Aged 40 Years: A Health Economic Analysis.

Pharmacoeconomics

December 2024

Health Economics and Policy Evaluation Research (HEPER) Group, Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia.

Background And Objective: Current Australian cardiovascular disease (CVD) prevention guidelines calculate 5-year CVD risk and recommend treatment when risk crosses specific thresholds. This may leave risk factors untreated for people with a low short-term (i.e.

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Trends in the incidence of young-adult-onset diabetes by diabetes type: a multi-national population-based study from an international diabetes consortium.

Lancet Diabetes Endocrinol

December 2024

Department of Diabetes and Population Health, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; School of Life Sciences, La Trobe University, Melbourne, VIC, Australia.

Background: Population-based incidence data on young-adult-onset type 1 diabetes and type 2 diabetes are limited. We aimed to examine secular trends in the incidence of diagnosed type 1 diabetes and type 2 diabetes with an age of onset between 15 and 39 years.

Methods: In this multicountry aggregate data analysis, we assembled eight administrative datasets from high-income jurisdictions and countries (Australia, Denmark, Finland, Hungary, Japan, Scotland, South Korea, and Spain [Catalonia]) that had appropriate data available from an international diabetes consortium (GLOBODIAB) describing incidence by diabetes type among people aged 15-39 years from 2000 to 2020.

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Globally, more than 1.2 billion inhalers are purchased for asthma and chronic obstructive pulmonary disease (COPD) annually. In Australia and New Zealand, pressurized metered dose inhalers (pMDIs) are the leading delivery device prescribed and pMDI salbutamol can be purchased over the counter in Australia.

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Gabapentinoids and Risk of Hip Fracture.

JAMA Netw Open

November 2024

Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia.

Importance: The increased use of gabapentinoids has been most pronounced in older people who are also susceptible to hip fractures.

Objective: To investigate the overall association between gabapentinoids and the risk of hip fractures and the stratified association across age groups, frailty status, and history of chronic kidney disease.

Design, Setting, And Participants: This was a case-case-time-control study in patients hospitalized for hip fracture in Victoria, Australia, between March 1, 2013, and June 30, 2018, with at least 1 prescription for a gabapentinoid before fracture.

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Global perspectives on opioid use: shifting the conversation from deprescribing to quality use of medicines.

BMJ Qual Saf

November 2024

Monash Addiction Research Centre (MARC), Eastern Health Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Frankston, Victoria, Australia.

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Background And Aims: This Australian population-based study investigated statin intensity after hospitalization for ischemic stroke in a matched cohort of people living with and without dementia.

Methods: We identified all patients aged ≥ 30 years hospitalized in the state of Victoria, Australia, for ischemic stroke from July 1, 2013 to April 30, 2018 from the Victorian Admitted Episodes Data set. People with dementia were matched 1:4 for sex, 5-year age group and index date ± 90 days with people without dementia.

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Pharmaceutical, Clinical, and Regulatory Challenges of Reformulating Pressurized Metered-Dose Inhalers to Reduce Their Environmental Impact.

J Aerosol Med Pulm Drug Deliv

November 2024

Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, Groningen, The Netherlands.

Article Synopsis
  • Early pressurized metered-dose inhalers (pMDIs) used chlorofluorocarbons (CFCs) as propellants, which harmed the ozone layer, leading to their phase-out under the 1987 Montreal Protocol.
  • Current pMDIs now use hydrofluoroalkanes (HFAs), like HFA-134a, which do not deplete ozone but contribute to global warming, prompting a gradual reduction in their use.
  • Instead of switching to dry powder inhalers (DPIs), which may not be suitable for all patients, an alternative is to reformulate pMDIs to use low-global warming potential propellants like HFA-152a, addressing environmental impact while considering patient
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Medication use in people with cystic fibrosis before and after modulator therapy.

Pulm Pharmacol Ther

October 2023

Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, 381 Royal Parade, Melbourne, Victoria, 3052, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.

Background: Long-term changes in medication dispensings post cystic fibrosis transmembrane conductance regulator (CFTR) modulator initiation have not been described. Our study aimed to investigate changes in medication use following the initiation of modulator therapy in people with cystic fibrosis (PwCF) in Australia.

Methods: Using a 10% sample of the Australian Pharmaceutical Benefits Scheme (PBS) data between 2013 and 2022, linear regression was used to analyse dispensings in PwCF who initiated any modulator (cases) and matched PwCF controls not dispensed a modulator.

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Non-optimum temperatures led to labour productivity burden by causing premature deaths: A multi-country study.

Environ Int

November 2024

Climate, Air Quality Research (CARE) Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia. Electronic address:

Article Synopsis
  • Non-optimum temperatures contribute significantly to premature deaths and labor productivity losses, with a focus on quantifying these impacts across several countries.
  • The study, which analyzed mortality data from 1,066 locations, found a U-shaped relationship between temperature and productivity-adjusted life-years (PALY) lost, with cold-related deaths having a more profound effect on older age groups and heat-related deaths affecting younger individuals.
  • Results indicated that socioeconomically vulnerable communities experience greater productivity losses due to non-optimal temperatures, highlighting the need for targeted interventions to mitigate these impacts.
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Minimising Harm and Managing Pain: Deprescribing Opioids in Older Adults.

Drugs Aging

November 2024

Faculty of Medicine and Health, School of Pharmacy, The University of Sydney, Rm 401, Badham Building A16, Camperdown, 2006, Sydney, NSW, Australia.

Approximately one in three older adults (aged 65 years and over) experience pain, negatively impacting their quality of life. Opioid analgesics are commonly prescribed to manage pain; however, balancing the benefits and harms of these high-risk analgesics can be challenging for both healthcare professionals and patients. This is particularly true for older adults, as factors such as polypharmacy, age-related physiological changes and cognitive decline may impact upon opioid safety and efficacy.

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