Understanding adverse drug events in ageing populations

Supervisor: Professor James Sheppard

As individuals age, they often develop multiple health conditions that necessitate the prescription of numerous medications. Some individuals many be prescribed an excessive number of medications, known as 'inappropriate polypharmacy' and this is associated with an increased risk of harm, including delirium, falls, bleeds and kidney problems. Medication-related harm accounts for 1 in 10 hospital admissions. Presently, doctors are asked to undertake regular medication reviews to avoid these harms, but do not always know which patients are most susceptible to experiencing such harms. One solution is to 'deprescribe' medications, this has not been evaluated widely in clinical trials, and outcomes remain unclear.

In this DPhil, the student will undertake a project using data from routine electronic health records (CPRD), focussing on one specific adverse drug event, and explore:

1. Which medications are most strongly associated with this adverse drug event (drug association study)
2. Which patients are at the highest risk of experiencing this adverse drug event (prediction modelling study)
3. Whether stopping potentially problematic medications is associated with greater benefit or harm (causal inference study)

Preferred applicant background/skills: Quantitative research background with an understanding of basic statistical methods. Experience using data from routine electronic health records would be desirable but not essential