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Is it safe to be taking all these pills?


Research is making it safer for old people to take their medications.

As people age and develop chronic diseases, many have to take a cocktail of drugs – but surprisingly little is known about how these are metabolised in older people or how they affect them, particularly when multiple drugs are used together. International research has shown
us that exposure to many different medications can have a cumulative effect, increasing chances of going to hospital, having falls and even
of dying.

Associate Professor Sarah Hilmer is working towards making drugs work better and more safely in people as they age. Combining laboratory work, clinical research and data analysis of large populations of older people, she is painting a picture of how we metabolise medications as we age and how medicines affect us in old age, alone and in combination.

She has designed a pharmacological risk assessment tool, the Drug Burden Index, which helps prescribers work out what level of medications are associated with functionalimpairment, falls and hospitalisation in studies of older people from Australia, USA and Europe.

She is currently developing software to calculate the Drug Burden Index to be trialled by pharmacists in Australia when they do home medicine reviews. “We are seeing whether this can reduce the number and dose of high risk drugs older people take and improve their outcomes,” says Sarah.

She is also studying what happens when you reduce medications in older people in residential aged care facilities. One project targets older people taking multiple medications and aims to reduce or cease medicines that are likely to be causing harm or unlikely to be helping patients.  Another aim to decrease the use of antipsychotic medicines in older people with dementia.

She conducts translational research on paracetamol, an analgesic that is used very commonly by older people.  Her laboratory and clinical research has found that the risk of liver toxicity from paracetamol actually decreases in old age. She is investigating why this is so, and her findings could provide future treatments to prevent drug-induced liver disease.  The finding has also informed dosing guidelines for paracetamol use in older people.