The Aged Care Evaluation and Research (ACER) Team

The Aged Care Evaluation and Research (ACER) Team

The Aged Care Evaluation and Research (ACER) team is part of the Centre for Health Systems and Safety Research at the Australian Institute of Health Innovation, Macquarie University. ACER comprises a collaborative, multidisciplinary team of researchers conducting world-class research relevant to residential and community aged care settings.

Older people receiving aged care services face widespread quality and safety issues due to the greater vulnerability and the rising healthcare needs of this growing population. The goal of ACER is to generate high-quality evidence through applied and translational research to improve health and service delivery outcomes in both residential and community aged care settings. Our researchers apply novel quantitative and qualitative research methodologies and sophisticated analytical approaches with a strong connection to consumer involvement to achieve this goal.

There are four interconnected research themes within ACER

Consumer-driven health services and informatics

Communities, consumers and health care providers are seeking effective ways to plan and manage the health and support services required to enable older adults to actively engage in society and maintain a high quality of life. Health information and communication technologies (ICT) can help meet these challenges. Examples of areas of interest of the team include:

  • Unlocking valuable data and integrating health and aged care information to answer important questions about care trajectories, outcomes, and strategies to improve practice with end-users, consumers and key stakeholders (e.g.., national aged care medication roundtable)
  • Evaluating the patient and health system impacts of health informatics interventions including clinical dashboards, digital health records and apps
  • Harnessing routinely collected electronic data to generate practice and policy-relevant evidence (e.g., developing learning health systems)
  • Optimising decision support tools to improve care, outcomes, and user experience
  • Monitoring and evaluating the impact of major health policy initiatives in aged care.
Geriatric pharmacoepidemiology & pharmacy informatics

Pharmacoepidemiology involves the application of epidemiological methods to study the use and effects of medications in real-world care settings. Pharmacy informatics is a subset of health informatics focusing on the intersection between information technology and medication use. The increasing availability of large, population-level, routinely collected electronic health data allow us to conduct cutting-edge pharmacoepidemiologic and pharmacy informatics studies in aged care. Examples of areas of interest include:

  • High-risk medication uses (e.g., psychotropics) and their effects on health outcomes
  • Medicine utilisation studies including trend analyses (e.g., antibiotic use, concordance of treatments against guidelines)
  • Monitoring and reporting of meaningful quality use of medicines indicators using informatics
  • Designing and testing novel informatics interventions to improve medication management.
Predictive and prescriptive analytics

Predictive analytics focuses on forecasting potential future events while prescriptive analytics provides recommendations based on predictions. Our researchers apply novel statistical and machine learning approaches to achieve this, using large electronic aged care providers and hospital admission data. An example of a project applying prescriptive analytics (i.e., predictive analytics dashboard with embedded decision support) can be found here. Examples of areas of interest include:

  • Development and validation of risk prediction and monitoring tools relevant to aged care settings
  • Designing and evaluating predictive analytical dashboard to support personalised aged care
  • Applications of advanced predictive modelling techniques (including machine learning) to support the safety and efficiency of aged care
  • Developing and testing novel web-based applications to examine variation in medication use
Chronic disease care and healthy ageing

Four in five Australians aged 65 and over have at least one chronic health condition causing significant health and economic burden. Our ACER team conduct both quantitative and qualitative studies to understand, monitor and optimise chronic disease care and healthy ageing in aged care. Examples of areas of interest include:

  • Monitoring and evaluating chronic disease epidemiology, appropriateness of pharmacotherapy, health outcomes and service utilisation (e.g., Parkinson’s disease, dementia, diabetes)
  • Engaging aged care clients, workforce and consumers in research to provide valuable insight into the needs and preferences of older people
  • Using information technology to monitor and optimise social participation and quality of life of people receiving aged care services
  • Development and evaluation of indicators of healthy life expectancy (e.g., depression-free life expectancy)

ACER team


Professor Johanna Westbrook
Professor and Director


Professor Andrew Georgiou
Professor



Associate Professor Ling Li
Associate Professor


Dr Virginia Mumford
Senior Research Fellow


Dr Magda Raban
Senior Research Fellow


Dr Md Bayzidur Rahman
Senior Research Fellow


Dr Nasir Wabe
Senior Research Fellow

 
Dr Tim Badgery-Parker
Research Fellow


Dr Amy Nguyen
Research Fellow


Dr Karla Seaman
Research Fellow


Dr Sandun Malpriya Silva
Research Fellow

Dr Andrea Timothy
Research Fellow


Dr Rachel Urwin
Research Fellow


Dr Ying Xu
Research Fellow


Dr Guogui Huang
Postdoctoral Research Fellow

Ms Arwen Blackwood-Ximenes
Research Assistant

Ms Joanna Clive
Research Assistant


Ms Desiree Chantelle Firempong
Research Assistant


Mr Cris Mercado
Research Assistant


Ms Isabelle Meulenbroeks
PhD Candidate and Research Assistant

 

Ms Narjis Batool
PhD Candidate

Ms Tanja Schroeder
PhD Candidate

Ms Bella St Clair
PhD Candidate
Topic: “The burden of adverse events in residential aged care: a person-centred approach to measuring quality and safety”
Supervisors: Professor Andrew Georgiou and Dr Mikaela Jorgensen.

Stream Coordinator

Dr Nasir Wabe
(02) 9850 2442

Follow us on @Acer_mq

ACER projects

See other ACER projects and initiatives

ACER news

 
New NHMRC Partnership Project in Aged Care

Macquarie University has been awarded $1.4 million in National Health and Medical Research Council funding for ‘A National Aged Care Medication Roundtable - Translating aged care data into action to improve quality of care through collaboration and co-design’.

Professor Johanna Westbrook will lead the Roundtable, designed to directly support national aged care policy and targets, Commonwealth national aged care quality indicators, along with recommendations from the Royal Commission.

This highly collaborative project will devise innovative and practical IT based solutions to address poor medication management which was the topic of more than one third of issues reported to the Royal Commission into Aged Care Quality and Safety and is the greatest source of complaint to the Aged Care Quality & Safety Commission.

For more information.

 
Aged care health status algorithms

Researchers within the Aged Care Evaluation and Research (ACER) team here at Macquarie University have developed aged care health status algorithms. The algorithms are free to access and download by national and international researchers looking to identify health conditions amongst older adults in residential aged care (nursing home) settings.

 
We are looking for PhD Candidates

Passionate about aged care, digital health or health systems?  Eager to improve service delivery and quality of life of older adults?

The Aged Care Evaluation and Research (ACER) team at the Australian Institute of Health Innovation (AIHI), Macquarie University has an opportunity for a PhD candidate to undertake research on an NHMRC funded partnership grant. The research involves developing and evaluating an electronic dashboard to improve the delivery of care to clients in residential and community aged care. The partners on this project, Sydney North Health Network (SNHN), Northern Sydney Local Health District, Anglicare, Aged Care Quality and Safety Commission and Australian Healthcare and Hospitals Association, will allow for strong potential for translation of the research and development of skills and connections within these industries. The successful candidate will have the opportunity to be co-located at the SNHN.

Interested? View the full scholarship details.

More ACER News

ACER initiatives

Osteoporosis: Underreporting and undertreatment in residential aged care facilities puts people at risk

Osteoporosis causes a significant reduction in bone density and currently affects over 1 million Australians. Although preventable, if the condition is not treated with medication, exercise and dietary changes older people can be at increased risk of fractures which can lead to chronic pain, increased dependency, functional decline, and premature death. Untreated osteoporosis will lead to an estimated 866 out of 100,000 women suffering from a hip or femur fracture within the span of a year. For older individuals with osteoporosis, even minor bumps could result in fracture cascades.

The first large study of osteoporosis medication use among people in Australian residential aged care facilities showed that osteoporosis is likely underreported in electronic health records. Based on international studies, 85% of people in residential aged care are expected to have osteoporosis. However, according to research by Dr Kim Lind and the ACER team at the Australian Institute of Health Innovation published in the journal of Health Services Insights the recognition of osteoporosis is much lower – only 34%.

Results from the study suggest that many people may not be receiving the PBS subsidised medication that would reduce their risk of fracture. Researchers speculate that since multiple chronic health conditions are common for people living in residential aged care facilities, osteoporosis remains unrecognised and not prioritised, leading to undertreatment and underreporting.

The Royal Commission in Aged Care Quality and Safety has highlighted that medication management is a leading concern. Osteoporosis identification and management is a prime example of where systematic monitoring of adherence to medication guidelines could quickly improve the care of our most vulnerable people. As a result of these findings from over 10,000 residents in 68 residential aged care facilities in NSW and ACT, Macquarie University researchers are urging for better recognition and treatment of osteoporosis for people living in aged care facilities.

Antidementia medication use: Implications for medication management in RACFs

Dementia is the second leading cause of death in Australia. It causes cognitive, behavioural and psychological changes as well as a loss of physical functioning. Currently, there are no disease-modifying treatments for dementia, but there are medications (cholinesterase inhibitors and memantine) that can improve symptoms and quality of life, but little is known about the use of these medications in Australia, and specifically in the residential aged care setting.

Researchers at Macquarie University conducted the first study to examine antidementia medication use in residents with dementia in Australian aged care facilities.

The findings, published in the International Journal of Geriatric Psychiatry, indicate that antidementia medication use is strikingly low compared to other countries and use decreased over the 3 year period. Lower levels of antidementia medication use was found in residents living in rural or regional facilities, suffering from multiple chronic health conditions,  with greater functional decline, and for foreign-born residents. Antidementia medications are rarely initiated after being admitted to a facility and majority of the sample were administered mild to moderate dementia medication rather than moderate to severe dementia medication, which is more common for people living in a high care setting.

Medication management is a priority for the Royal Commission in Aged Care Quality and Safety and the research by Dr Kim Lind and the ACER team demonstrates that medication monitoring in RACFs is possible with existing electronic health record data.

Researchers suspect that Australian subsidy restrictions may be a barrier to accessing these medications. Additionally, facilities in remote areas may have particularly limited access to specialist consultations to obtain or confirm a dementia diagnosis – a necessary step in order to qualify for PBS subsidisation. Macquarie University researchers call for an increased focus on antidementia medication assessment and review, and use of electronic health record data for improving the quality of aged care for people with dementia.

See other ACER projects and initiatives

ACER in the media

Predictive falls risk model for aged care

Dr Karla Seaman attended the Australian Association of Gerontology national conference this week and reported on the research currently being undertaken in the Aged Care Evaluation and Research (ACER) team working with aged care provider Anglicare to develop a predictive falls risk model for the aged care sector. This research was reported on in Australian Ageing Agenda, please see the full article here.

Behaviour-related harm in aged care facilities

A recent study by Bella St Clair, PhD Candidate reveals that behaviour-related harm is almost as likely to contribute to adverse events in aged care facilities as falls. To learn more about the study please see recent media coverage in Australian Ageing Agenda and the journal article Incidence of adverse events in residential aged care in Australian Health Review.

Antibiotic use is higher in Australia's residential aged care facilities than in other countries

Dr Magda Raban is interviewed by Aged Care Insite on our recent research comparing the use of antibiotics in residential aged care facilities internationally,  Temporal and regional trends of antibiotic use in long-term aged care facilities across 39 countries, 1985-2019: Systematic review and meta-analysis.

To read the article, please visit Aged Care Insite.

More ACER Media

Recent ACER publications

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