The Safety And Effectiveness Of Hospital E-prescribing Systems: A Controlled Time Series Study
Funder
National Health and Medical Research Council
Funding Amount
$740,460.00
Summary
Prescribing errors represent a significant public health issue internationally. In the US over 770,000 people are harmed or die each year in hospitals as a result of adverse drug events. In Australia 2% of hospital patients experience harm or death due to medication errors. The risk of these errors is rising each year with the increased intensity of medical care, use of complex and potent drug regimens and the increasing age and severity of hospital patients. Electronic prescribing systems are b ....Prescribing errors represent a significant public health issue internationally. In the US over 770,000 people are harmed or die each year in hospitals as a result of adverse drug events. In Australia 2% of hospital patients experience harm or death due to medication errors. The risk of these errors is rising each year with the increased intensity of medical care, use of complex and potent drug regimens and the increasing age and severity of hospital patients. Electronic prescribing systems are believed to significantly reduce the number of errors which occur and reduce harm to patients as a result. No studies have demonstrated that these systems result in reducing prescribing errors that cause harm to patients. Alarmingly, anecdotal evidence from overseas suggests that use of electronic prescribing systems introduces new types of errors. This is consistent with a growing body of scientific research which suggests that individuals' decision-making may be significantly influenced by information generated by a computer, resulting in new types of errors. The aim of this project is to undertake a controlled time series study to assess the safety and effectiveness of two electronic prescribing systems to reduce prescribing errors in Australian hospitals. The study will compare error rates before and after the introduction of the systems. In addition, the study will be the first to focus on measuring new types of errors that may result from system use and to investigate how computer use influences clinicians' decision-making. This study will provide critical information about the effectiveness and safety of these systems which are being introduced into Australian hospitals. Unlike other medical interventions, which require stringent safety testing before use with patients, there are no minimum safety requirements for electronic prescribing systems. The data from this study is urgent in developing recommendations to ensure the safety of electronic prescribing systems for Australia.Read moreRead less
Evaluating The Safety Of Computer Decision Support Systems In General Practice
Funder
National Health and Medical Research Council
Funding Amount
$300,389.00
Summary
Use of clinical software has many benefits. However it is also likely that clinical software will introduce new computer-generated errors that may harm patients. This project will evaluate the safety of software for prescribing in general practice. We will firstly examine mechanisms for errors generated by clinical software on its own, and then in the hands of typical users. The outcomes will have broad potential to guide the regulation, use and design of clinical software in general practice.
Reducing CVD Risk In The Metabolic Syndrome And Type 2 Diabetes: Novel Approaches To Studies Of Lipoprotein Metabolism
Funder
National Health and Medical Research Council
Funding Amount
$548,669.00
Summary
The incidence of obesity and diabetes is increasing in Australia. With these two conditions comes an increase in cardiovascular disease risk. Elevated blood lipids are an important component of this increased. Weight loss and cholesterol lowering drugs are first line therapies for obesity and diabetes, respectively. Niacin is effective at lowering lipids and raising HDL cholesterol, but the mechanisms responsible for these changes have not been determined.
Targeting KRAS Mutations In Cancer Using A Novel SiRNA Delivery Technology
Funder
National Health and Medical Research Council
Funding Amount
$498,899.00
Summary
Mutations in a gene called KRAS are found in 20% of human cancers but are impossible to target with existing treatments. RNA interference is a promising new way to target genes previously considered undruggable, but there is no way to deliver the molecules required for RNA interference to tumours. We will evaluate the ability of a new nanotechnology based delivery system (antibody targeted minicells) to deliver RNA interference, thereby selectively targeting of KRAS in tumours while avoiding tox ....Mutations in a gene called KRAS are found in 20% of human cancers but are impossible to target with existing treatments. RNA interference is a promising new way to target genes previously considered undruggable, but there is no way to deliver the molecules required for RNA interference to tumours. We will evaluate the ability of a new nanotechnology based delivery system (antibody targeted minicells) to deliver RNA interference, thereby selectively targeting of KRAS in tumours while avoiding toxicity to normal tissue.Read moreRead less
Current treatments for chronic pain are limited in their success. This emphasises the need for new insights into the basic mechanisms and nervous system circuitry underlying altered or chronic pain states. Work in animals and patients with chronic pain shows that certain brainstem centres communicate, via descending spinal cord pathways, with small nerve cells in the superficial dorsal horn (SDH) of the spinal cord. These SDH neurones receive and process pain-signalling information from the skin ....Current treatments for chronic pain are limited in their success. This emphasises the need for new insights into the basic mechanisms and nervous system circuitry underlying altered or chronic pain states. Work in animals and patients with chronic pain shows that certain brainstem centres communicate, via descending spinal cord pathways, with small nerve cells in the superficial dorsal horn (SDH) of the spinal cord. These SDH neurones receive and process pain-signalling information from the skin and internal organs, and receive inputs from descending pathways. This descending input can either inhibit or enhance the activity of SDH neurones and subsequent pain perception. Till now it has been difficult to directly examine how descending pain pathways influence the small SDH neurones in the spinal cord. A new approach, which has been developed in our laboratory, now allows us to record from these very small SDH neurones in the spinal cord of an intact deeply anaesthetized mouse. In addition, our technique allows us to examine the recorded SDH neurone s responses to functionally relevant stimuli (brushing or pinching the hindpaw) as well as its physiology and anatomy. This project will use our new techniques to examine the effects of activating descending brainstem pathways that alter the way painful stimuli are processed in the spinal cord. The effects of altered levels of inhibition in the spinal cord will also be studied by using mice with naturally occurring mutations in their inhibitory glycine receptors. We believe a more complete understanding of pain processing mechanisms will be achieved by examining the role of descending pathways in an intact animal preparation. Such data are essential for the development of drug therapies that can successfully target pain syndromes.Read moreRead less