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Rehabilitation and Aged Care Network

 

The NSLHD Rehabilitation and Aged Care Network includes research in the areas of;

  • ageing, aged care and dementia, carried out through the Curran Ageing Research Unit at Hornsby Ku-ring-gai Hospital, and the Penney Ageing Research Unit at Royal North Shore Hospital, and
  • research in rehabilitation of trauma in all ages, and in disability in older people, carried out through the John Walsh Centre for Rehabilitation Research.
  • There are also a number of nursing and allied health clinicians involved in clinical research projects within rehabilitation and aged care services.

 

Key staff members include Professor Ian Cameron in the John Walsh Centre for Rehabilitation Research, Professor Sarah Hilmer in the Penney Ageing Research Unit, and Professor Sue Kurrle in the Curran Ageing Research Unit. The group supervised seven PhD students across the District over the last year.

 Selected Research Projects

  • The Confused Hospitalised Older Persons program (CHOPs) has been implemented in Hornsby Ku-ring-gai Hospital, leading to improved care of older patients with cognitive impairment.
  • The Asia Pacific Clinical Practice Guideline for the Management of Frailty is being put into practice through work led by the NSLHD Rehabilitation and Aged Care Network. Frailty screening is being taken up across care settings and used to inform patient care. In the admitted setting, Hornsby Hospital has established frailty screening, targeted allied health and detailed advice to GPs on discharge as part of routine practice on medical wards.
  • The Drug Burden Index was developed and is used a clinical risk assessment tool to guide medication review in older patients implemented in practice through various agencies. eHealth NSW piloted the calculator and a clinician interface was co-designed. As well, deprescribing guides and consumer medicines information is available to clinicians through NSW Therapeutic Advisory Group website. Finally, a NSW HETI module on polypharmacy and medication review in hospital is now available.

 Selected grants

Kurrle S, Crotty M, Cameron I, Sherrington C, Pond D, Nguyen T, Laver K, Howard K. The FORTRESS Study (Frailty in Older People: Rehabilitation Treatment Research Examining Separate Settings). NHMRC Targeted Call for Research into Frailty (ID 1177847). 2020-2022. $1,470,000.


Rowe C, Sachdev P, Naismith S, Breakspear M, Brodaty H, Anstey K, Martins R, Ward S, Vickers J, Masters C, Kurrle S, Schofield P, Ahern S. The Australian Dementia Network (ADNeT): Bringing together Australia’s dementia stakeholders. NHMRC Boosting Dementia Research Grant (Grant ID 1152623) 2018 – 2022. $18,000,000.
Nguyen TA, Kim BG, Brodaty H, Pham T, Roughead EE, Pham LT, Crotty M, Kurrle S, Hinton WL, Esterman A. Strengthening responses to dementia: Building an evidence platform for the development of a Vietnam National Dementia Plan. NHMRC-NAFOSTED Collaborative Research Projects (Grant ID 1154644) 2018 – 2020. $850,705.


Hilmer S, Gnjidic D, Reeve E, Etherton-Beer C, Magin P, Bell JS, Kelly P. Optimising quality use of medicines in hospital to improve outcomes in frail older people. NHMRC Targeted Call for Research on Frailty. 2020-2025. $1.2 million.


Peleg A, Haines T, Cheng A, Peel T, Holt K, Hilmer S, Jeon Y, Stewardson A, Spelman T. MRFF. Stepped-wedge Trial to increase antibiotic Appropriateness in Residential aged care facilities and model Transmission of antimicrobial resistance (The START Research Program); 2018-2021.


Chief Investigators: Baysari M, Li L, Westbrook J, Day R, Hilmer S. Optimising computerised decision support to transform medication safety and reduce prescriber burden Partnership Grant, NHMRC 2017-2021. $830,545.


CIs: Jeon Y, Simpson J, Low L, Mowszowski L; AI: Hilmer SN Optimising functional independence of older persons with dementia: Implementation and Evaluation of the Interdisciplinary Home-bAsed Reablement Program (I-HARP) National Health and Medical Research Council (NHMRC)/Boosting Dementia Research Grants, 2017-2020.

Morris M, Hill A, Haynes T, Cameron ID, McPhail S, Gray R, Kiegaldie D, Carey L, Webster K, Mitra D. A Public-Private Partnership to Reduce Falls in Australian Hospitals. 2018-2021. NHMRC Partnership Grant (APP1152853). $556,085


Braithwaite G, Cameron ID, Kitson A, Reed R, Georgiou A, Gray L. CareTrack Aged: appropriate care delivered to Australians living in residential aged care. 2018- 2021. NHMRC Project Grant (APP1143223). $1,158,000.

 Selected publications

Kurrle S, Bateman C, Cumming A, Pang G, Patterson S, Temple A. Implementation of a model of care for hospitalised older persons with cognitive impairment (the Confused Hospitalised Older Persons program) in six New South Wales hospitals. Australasian Journal on Ageing. 2019. doi: 10.1111/ajag.12690*

Wilson M, Tran Y, Wilson I, Kurrle S. Development of the Australian Ageing Semantic Differential, a New Instrument for Measuring Australian Medical Student Attitudes Towards Older People. Australasian Journal on Ageing. 2019. 38 (3): e67-e74. http://dx.doi.org/10.1111/ajag.12627 *


Chronic polypharmacy with increasing Drug Burden Index (DBI) exacerbates frailty and impairs physical function, with effects attenuated by deprescribing, in aged mice. Mach J, Gemikonakli G, Logan C, Vander Wyk B, Allore H, Ekambareshwar S, Kane AE, Howlett SE, de Cabo R, Le Couteur DG, Hilmer SN. J Gerontol A Biol Sci Med Sci. 2020 Mar 9:glaa060. doi: 10.1093/gerona/glaa060. Online ahead of print. PMID: 32147704.


Kouladjian-O'Donnell L, Gnjidic D, Sawan M, Reeve E, Kelly P, Chen T, Bell JS, Hilmer SN. Impact of the Goal-directed Medication review Electronic Decision Support System (G-MEDSS) on Drug Burden Index: a cluster-randomised clinical trial in primary care. British Journal of Clinical Pharmacology, accepted 22/8/2020.
Reducing the Burden of Complex Medication Regimens: SImplification of Medications Prescribed to Long-tErm care Residents (SIMPLER) Cluster Randomized Controlled Trial. Sluggett JK, Chen EYH, Ilomäki J, Corlis M, Van Emden J, Hogan M, Caporale T, Keen C, Hopkins R, Ooi CE, Hilmer SN, Hughes GA, Luu A, Nguyen KH, Comans T, Edwards S, Quirke L, Patching A, Bell JS. J Am Med Dir Assoc. 2020 Mar 13:S1525-8610(20)30186-9. doi: 10.1016/j.jamda.2020.02.003. Online ahead of print. PMID: 32179001


Development of consumer information leaflets for deprescribing in older hospital inpatients: a mixed-methods study. Jokanovic N, Aslani P, Carter S, Duong M, Gnjidic D, Jansen J, Le Couteur D, Hilmer S. BMJ Open. 2019 Dec 11; 9(12):e033303. doi: 10.1136/bmjopen-2019-033303. PMID: 31831548.


Baysari, M., Duong, M., Zheng, W., Nguyen, A., Lo, S., Ng, B., Richie, A., Le Couteur, D., McLachlan, A., Bennett, A., Hilmer, S. (2019). Delivering the right information to the right person at the right time to facilitate deprescribing in hospital: a mixed methods multisite study to inform decision support design in Australia. BMJ Open, 9(9), 1-9.

 
Withdrawal of antihypertensive drugs in older people. Emily Reeve, Vanessa Jordan, Wade Thompson, Mouna Sawan, Adam Todd, Todd M Gammie, Ingrid Hopper, Sarah N Hilmer, Danijela Gnjidic. Cochrane Systematic Review - Intervention Version published: 10 June 2020. https://doi.org/10.1002/14651858.CD012572.pub2


Frailty in the Face of COVID-19. Hubbard RE, Maier AB, Hilmer SN, Naganathan V, Etherton-Beer C, Rockwood K. Age Ageing. 2020 May 6:afaa095. doi:10.1093/ageing/afaa095. Online ahead of print. PMID: 32374368.


Optimising medication management during the COVID‐19 pandemic. Ian A. Scott, Debbie Rigby, Sarah N. Hilmer. Journal of Pharmacy Practice and Research. First published: 04 July 2020 https://doi.org/10.1002/jppr.1668


Korall AMB, Feldman F, Yang Y, Cameron ID, Leung PM, Sims-Gould J, Robinovitch SN. Effectiveness of Hip Protectors to Reduce Risk for Hip Fracture from Falls in Long-Term Care. J Am Med Dir Assoc. 2019 Aug 30. pii: S1525-8610(19)30562-6. doi: 10.1016/j.jamda.2019.07.010.

Walker P, Kifley A, Kurrle S, Cameron ID. Process outcomes of a multifaceted, interdisciplinary knowledge translation intervention in aged care: results from the vitamin D implementation (ViDAus) study. BMC Geriatr. 2019 Jun 25;19(1):177. doi: 10.1186/s12877-019-1187-y.


Sheehan KJ, Fitzgerald L, Hatherley S, Potter C, Ayis S, Martin FC, Gregson CL, Cameron ID, Beaupre LA, Wyatt D, Milton-Cole R, DiGiorgio S, Sackley C. Inequity in rehabilitation interventions after hip fracture: a systematic review. Age Ageing. 2019 Apr 9. pii: afz031. doi: 10.1093/ageing/afz031.


Achterberg WP, Cameron ID, Bauer JM, Schols JM. Geriatric Rehabilitation-State of the Art and Future Priorities. J Am Med Dir Assoc. 2019 Apr;20(4):396-398. doi: 10.1016/j.jamda.2019.02.014.


Crotty M, Killington M, Liu E, Cameron ID, Kurrle S, Kaambwa B, Davies O, Miller M, Chehade M, Ratcliffe J. Should we provide outreach rehabilitation to very old people living in Nursing Care Facilities after a hip fracture? A randomised controlled trial. Age Ageing. 2019 Feb 22. pii: afz005. doi: 10.1093/ageing/afz005.


Sheehan KJ, Smith TO, Martin FC, Johansen A, Drummond A, Beaupre L, Magaziner J, Whitney J, Hommel A, Cameron ID, Price I, Sackley C. Conceptual Framework for an Episode of Rehabilitative Care After Surgical Repair of Hip Fracture. Phys Ther. 2019 Mar 1;99(3):276-285. doi: 10.1093/ptj/pzy145.