Clinical Pharmacology and Toxicology

Background:

• Therapeutic Drug Monitoring (TDM) is an integral part of Quality Use of Medicines. 
• TDM enables personalisation of treatment and is used when:
  • the difference between toxic and effective dose is small.
  • measuring the desired clinical effect is difficult or delayed.
  • the condition being treated relies critically on the medicine.
• TDM can help optimise treatment and avoid adverse drug events. 
• The CPT Department is a national and international leader in TDM.
• State-of-the-art HPLC and mass spectrometry laboratory.

Example projects:

• Evaluation of routine drug monitoring data to describe novel drug interactions.
• Impact of haemodialysis on antibiotics pharmacokinetics.
• Capillary blood sampling to guide TDM. 
• Using genetic information to guide clinical decision-making (pharmacogenomics).

Background:

• The way we use medicines has a systemic, social and cultural context.
• Understanding how medicines are used and monitored in clinical workflow allows us to gain insight into implementation barriers, and facilitators of best practices. 
• We can use this information to adapt and design clinical interventions to optimise the use of medicines.
• A combination of qualitative (including interviews, focus groups, observational studies) and quantitative (including audits, surveys) methods helps us to evaluate clinical services, providing meaningful outcomes that ensure continuous improvement and sustained uptake. 

Available projects:

• Economic evaluation of TDM.
• Observational studies of pharmacist workflow – how are they talking?
• Telepharmacy – Service adaptations for the post-COVID era.
• A mixed-methods approach to understand the nature of accidental Poisonings in older Australians reported to the NSW Poisons Information Centre.
• The patient perspective: Understanding medication management for patients with breast cancer.
• Using national and state health, medication and administrative data sets to test hypotheses regarding medication usage and outcomes trends.
• Evaluating routine medication use data to identify priority areas for medication management in people from vulnerable populations.

Background:

• Illicit drug use can be associated with significant toxicity. 
• Little is known about the extent and range of drug use at music festivals. 
• The incidence of GHB overdose and dependence is increasing.
• Patterns of morbidity related to opioid overdose are largely unknown.
• The understanding of accelerated ageing in the context of illicit drug use is evolving.

Example projects:

• Wastewater analysis for illicit drugs at night time music venues.
• GHB overdose management and prevention.
• Management of GHB dependence.
• Understanding morbidity and outcomes of non-fatal opioid overdose.
• Frailty assessment in people who use alcohol or other drugs.

Background: 

• There is increasing interest in psychedelic psychotherapy for a range of conditions.
• Little is known about the prevalence and patterns of use of psychedelics in Australia. 

Example projects:

• Designing/implementing a survey of people who regularly use psychedelics.
• Systematic reviews of psychedelic psychotherapy topics.
• Clinical trials of psychedelic psychotherapy for a range of conditions.

Background:

• Gout is the most common form of inflammatory arthritis in men, characterised by extreme pain and swelling caused by elevated uric acid in the blood. 
• It is a chronic condition requiring life-long medication and self-management.
• Urate-lowering therapy can lower urate in the blood and prevent gout flares.
• Patients’ understanding is important to use these medicines well, and to ensure regular urate monitoring that enables 'treatment to target’.

Available projects:

• Evaluating the relationship between urate concentrations and patient-reported outcomes.
  
• Optimising gout treatment in people with kidney disease.  
• Evaluation of a Pharmacist-led chronic care delivery model in people with gout.
• Development and evaluation of educational materials for people with gout.
• Use of electronic apps to promote self-management in people with gout.