ORCID Profile
0000-0002-8126-5582
Current Organisations
University of Newcastle School of Medicine and Public Health
,
Hunter New England Imaging
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Publisher: Wiley
Date: 08-2018
DOI: 10.1111/BCP.13695
Publisher: Wiley
Date: 09-08-2019
DOI: 10.1111/BCP.14057
Publisher: Wiley
Date: 07-08-2018
DOI: 10.1111/BCP.13710
Publisher: Elsevier BV
Date: 11-2016
DOI: 10.1016/J.MATURITAS.2016.06.021
Abstract: There are a number of complex and seemingly ignored issues around prescribing safely and effectively for older people, particularly for very old women. These issues include polypharmacy, possible compliance issues and communication barriers between patient, specialists and general practitioners (GPs). There are specific pharmacokinetic (PK) and pharmacodynamic (PD) parameters that change in older age generally, and in women more specifically, which if ignored are likely to cause symptoms and to impair quality of life when drug dosage is unchanged. These changed PK and PD parameters are not all-or-nothing processes, but a continuum across age, sex and comorbidity. Very old people also have less 'reserve' when drugs are used in 'standard' doses, are more likely to have multiple concurrent therapies, and the risk of adverse effects of drugs in this group is very high. Doctors need to consider these issues when providing therapy for this group, or when trying to unravel the complex prescribing cascade here. This review outlines general principles to consider when prescribing for older people, focusing on age- and sex-related changes in both PK and PD processes.
Publisher: Wiley
Date: 11-2016
DOI: 10.1111/IMJ.13250
Publisher: Wiley
Date: 22-06-2023
DOI: 10.1111/BCP.15814
Abstract: The UK Prescribing Safety Assessment was modified for use in Australia and New Zealand (ANZ) as the Prescribing Skills Assessment (PSA). We investigated the implementation, student performance and acceptability of the ANZ PSA for final‐year medical students. This study used a mixed‐method approach involving student data ( n = 6440) for 2017–2019 (PSA overall score and 8 domain subscores). Data were also aggregated by medical school and included student evaluation survey results. Quantitative data were analysed using descriptive and multivariate analyses. The pass rate was established by a modified Angoff method. Thematic analyses of open‐ended survey comments were conducted. The average pass rate was slightly higher in 2017 (89%) which used a different examination to 2018 (85%) and 2019 (86%). Little difference was identified between schools for the PSA overall performance or domain subscores. There was low intercorrelation between subscores. Most students provided positive feedback about the PSA regarding the interface and clarity of questions, but an average of 35% reported insufficient time for completion. Further, 70% on average felt unprepared by their school curricula for the PSA, which is in part explained by the low prescribing experience 69% reported completing ≤10 prescriptions during training. The ANZ PSA was associated with high pass rates and acceptability, although student preparedness was highlighted as a concern for further investigation. We demonstrate how a collaboration of medical schools can adapt a medical education assessment resource (UK PSA) as a means for fulfilling an unmet need.
Location: Australia
Location: Australia
No related grants have been discovered for Catherine Lucas.