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Medication use among nursing home residents
Emma Bjørk Olsen
This project aims to study medication use among Danish nursing home residents, leveraging newly available data from the Danish Health Data Authority. The research comprises four studies: 1) assessing the value of using information recorded in the Danish National Prescription Register to evaluate drug use among nursing home residents, 2) analyzing the utilization of pain medication at nursing homes, 3) examining the distribution of types of prescribers at nursing homes, and 4) evaluating the effect of designated nursing home physicians on residents' overall medication burden and prevalence of polypharmacy.
The project seeks to promote rational medication use, care, and safety for older persons living in Danish nursing homes by providing insights into the medication burden and developing interventions and strategies for systematic monitoring and evaluation.
Main supervisor: Anton Pottegård
Hypothesis-free screening of prescription medications for cardiovascular adverse effects
Saad Hanif Abbasi
This project aims to conduct hypothesis-free screening across all prescription medicines for a range of cardiovascular outcomes, which can be hypothesized to manifest both shortly after drug initiation and following prolo nged use. The overall project consists of two screening and two methodological studies. In the screening studies, we plan to screen for both cumulative effects, using case-control methodology, as well as effects of ‘new/current use’, using the case-time control. Signals generated by these studies will be prioritized for replication in future studies using external data sources. In the methodological studies, we will use the self-controlled design to investigate when the association between rofecoxib use and cardiovascular outcomes would have been identified using this setup and we will adapt the high-dimensional propensity score algorithm to the case-control screening design.Main supervisor: Anton Pottegård
Epidemiological screening of big data for unsuspected collateral drug benefits – a potential pipeline for drug repurposing
Martin Torp Rahbek
The project aims to locate unknown collateral drug benefits. A collateral drug benefit is when a drug has beneficial effects which are unrelated to the reason for prescribing it. The studies will be carried out by conduction of a hypothesis-free screening of real-world data of all prescriptions against all diagnoses. The overall project consists of three studies. Two screenings for respectively immediate and cumulated drug effects. The screening study of immediate effects utilizes the self-controlled design of the sequence symmetry analysis. In the screening for cumulated drug effects, we will use a nested case-control design. The last study is a scoping review describing the epidemiological aspects of analyzing cumulative drug effects, harmful or beneficial. Since all obtained associations are hypothesis generating they will be prioritized based on public health for validation and replication in future studies.
Main supervisor: Jesper Hallas
Real-world evidence for assessing drug use, effectiveness, and safety in childhood
Helene Kildegaard Jensen
This project aims to study the use, effectiveness, and safety of common medical treatments in children by conducting four research studies. Historically, children have been excluded from many clinical trials due to ethical concerns, feasibility issues, and high costs, resulting in a lack of data on the safety and effectiveness of many medications used in childhood. This project seeks to bridge this gap by using real-world data from Denmark's high-quality, nationwide databases.
The first study will examine trends in prescription drug use among children and adolescents, identifying potential areas for further research. The second study, already published, investigates the risk of adverse events after pediatric SARS-CoV-2 infection and the effectiveness of the Pfizer-BioNTech vaccine in adolescents. The third study will analyze the uptake and effectiveness of the influenza vaccine in children aged 2 to 6. Finally, the fourth study will examine the potential link between prenatal exposure to selective serotonin reuptake inhibitors (SSRIs) and the risk of functional gastrointestinal disorders in children.
Main supervisor: Anton Pottegård
Individualized immunosuppression in kidney transplanted patients
Katrine Agergaard Sørensen
The PhD project aims to investigate if the anti-rejection treatment of patients with a kidney transplant can be improved, which might lead to fewer kidney rejections and a longer life span of transplanted kidneys.
The anti-rejection medicine tacrolimus is necessary to prevent kidney rejection and it is routine to measure tacrolimus in all patients’ blood at regular intervals and to adjust the dose accordingly to minimize adverse events and organ rejection. We want to investigate if tacrolimus measured inside the immune cells in the blood is a much better measure of how tacrolimus is affecting the body in order to individualize the treatment more in the future.
Main supervisor: Troels K. Bergmann
Supporting safe use of antibiotics: Penicillinase-resistant penicillins as inducers of drug metabolism and drug transporters
Ditte Bork Iversen
This project aims to support the safe and rational use of the penicillinase-resistant antibiotics, dicloxacillin and flucloxacillin. We will perform two clinical studies and one register-based study. The clinical studies will elucidate if flucloxacillin increases drug metabolism in healthy volunteers and if dicloxacillin causes drug-drug interactions through induction of drug transporters. Furthermore, we will determine whether dicloxacillin and flucloxacillin induce their own metabolism potentially causing reduced antimicrobial efficacy over time. The register-based study will investigate the clinical relevance of the inductive potentials of dicloxacillin and flucloxacillin by assessing a potential increased risk of ischemic stroke or systemic embolism in patients on oral anticoagulants when treated with these antibiotics.
Main supervisor: Tore B. Stage
The effect of glucose and inflammation on drug metabolism in a 3D spheroid model of primary human hepatocytes
Andreas Ludvig Ohm Svendsen
In our project, we aim to investigate the effect of altered levels of glucose and inflammatory cytokines on drug metabolism in a 3D spheroid model of primary human hepatocytes. The initiation of glucose-lowering drugs in people with diabetes has been shown to alter drug metabolism in vivo. However, previous in vitro studies have not provided meaningful in vitro-in vivo correlation, mainly due to limitations in methodology and the use of supraphysiological levels of inflammatory cytokines.
To bridge this gap and gain more insights into the effects of glucose and inflammation on drug metabolism, we will use a novel 3D model of primary human hepatocytes, which better represents the morphology and function of the human liver. By manipulating the levels of glucose and inflammatory cytokines in this model, we hope to gain a better understanding of how these factors affect drug metabolism.
The findings of our study may have implications for personalized medicine in the future. Furthermore, the 3D spheroid model of primary human hepatocytes may represent a new standard for high-throughput in vivo human drug metabolism studies, as it more closely mimics the in vivo environment.
Overall, the project has the potential to contribute to understanding drug metabolism and its regulation in the context of diabetes and inflammation.
Main supervisor: Tore B. Stage
Use of Real-World Data in screening for unknown drug effects and drug utilisation patterns within dermatology
Thomas Delvin
Monitoring of marketed drugs is an important part of the ongoing evaluation of the benefits and risks of drugs, and epidemiological analyzes of healthcare data have been proposed as an alternative to traditional side-effect monitoring.
Monitoring of marketed drugs is a critical aspect of assessing the benefits and risks associated with their use. To this end, epidemiological analyses of healthcare data have been proposed as a valuable alternative to traditional side-effect monitoring.
In this project, we aim to apply epidemiologic screening to large healthcare databases to evaluate its utility in the field of dermatology. Our approach will involve conducting three key studies. 1) A study screening all dermatology drugs for adverse and beneficial effects by using self-controlled designs and a nested case-control analysis. 2) A study screening all marketed drugs for dermatological adverse outcomes using the same designs. 3) A comprehensive dermatology drug utilisation study screening for unexpected utilisation patterns.
Main supervisor: Jesper Hallas
Public Health Research in the Danish Community Pharmacy setting
Alaa Hassan Burghle
In Denmark, patients can go to any community pharmacy, with no appointment, and receive counselling on the safe and effective use of medication. In addition to the usual counselling a number of pharmaceutical care services are provided. This setting makes the community pharmacy an excellent data-provider for research projects as its platform can e.g. be used to collect information from patients on side effects not otherwise available through other means or targeting inappropriate use of medications through pharmaceutical care. With this PhD-thesis we aim to further explore and strengthen the possibility of conducting public health research projects in the Danish community pharmacy setting. We will achieve this through the conduct of three research projects, each utilizing different methods: a randomized controlled trial, a qualitative study, and a survey.
Main Supervisor: Anton Pottegård