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PhD student from School of History, Heritage and Society undertakes groundbreaking research on drug reactions in older Australians
Older Australians are at increasing risk of experiencing serious adverse drug reactions. These adverse reactions frequently occur after older patients are prescribed new drugs that have come on the market. Older patients can be more vulnerable because they are more likely to have other illnesses, and they are more likely to be taking other medications to treat these other illnesses. They are also not as strong as younger patients, and are less able to cope with side-effects that may be associated with a new drug.
Clinical trials of new drugs are designed to evaluate the effect of one new drug on one illness. The most important issue of concern for older Australians taking new prescription drugs is that the patients who have taken part in the clinical trials for these new drugs are not similar to real-life older patients. The scientific reason given for excluding patients who have other illnesses and who take other medications is the need to make sure that the effects of the new drug are not confused by the effects of these other illnesses and medications. However, older patients who already have other illnesses and who take other medications are often the very patients who will be prescribed the new drug designed to relieve just one of those illnesses.
It is essential to identify the patients who are at risk if they are prescribed a new drug. Older patients whose health profiles match those of patients excluded from the clinical trials of a new drug are at risk. This is because we simply do not know how the new drug will interact with excluded illnesses and excluded medications. We recommend that identification of at-risk groups should be undertaken prior to the inclusion of a new drug in the PBS schedules. The process will require an examination of reports of the clinical trials for new drugs, and an examination of de-identified administrative health data to identify common illnesses and medications in patients who have the illness that is the target of a new drug. The recommendation is that patients who are found to be at risk are not prescribed the new drug.