Michael J Dooley

Alfred Hospital, Melbourne, Victoria, Australia

Are you Michael J Dooley?

Claim your profile

Publications (79)241.11 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Clinical medication review (CMR) is a structured and collaborative service aimed at identifying and resolving medication-related problems (MRPs). This is the first systematic review of CMR research in Australia. To systematically review the processes and outcomes of CMR in community-settings in Australia. MEDLINE, EMBASE, International Pharmaceutical Abstracts (IPA), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library and the grey literature were searched from 2000 to February 2015. All study designs were considered. Data extraction and quality assessment were performed independently by two investigators. Nine controlled studies, 34 observational and uncontrolled studies, 11 qualitative studies (focus groups and interviews) and nine survey studies were included. The CMRs resulted in identification of MRPs (n = 15 studies, mean 3.6 MPRs per CMR) and improved adherence (n = 3). Reductions in numbers of medications prescribed (n = 3 studies), hospitalizations (n = 3), potentially inappropriate prescribing (n = 3) and costs (n = 6) were demonstrated. Comparisons to a control group, predominately non-recipients of CMR, were made in eleven of 43 studies. Evidence supports additional models that promote interprofessional collaboration and timely referral following hospital discharge. Qualitative research identified low awareness of CMR among eligible non-recipients, while benefits were perceived to outweigh barriers to implementation. Underserved populations include indigenous and culturally and linguistically diverse people, recipients of palliative care, those recently discharged from hospital, people with poor medication adherence, those in rural and remote areas, older males, and younger people with long-term, persistent or serious health problems. The available evidence suggests CMR is beneficial in improving the quality use of medications and health outcomes. However, lack of comparator groups in many observational studies limited the strength of conclusions in relation to the impact on clinical outcomes. Addressing access gaps for underserved populations, implementing additional referral pathways, and facilitating greater collaboration between the health professionals represent opportunities for further improvement. Copyright © 2015 Elsevier Inc. All rights reserved.
    Research in Social and Administrative Pharmacy 07/2015; DOI:10.1016/j.sapharm.2015.06.007 · 2.35 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: A partnered medication review and charting model involving a pharmacist and medical officer was implemented in the Emergency Short Stay Unit and General Medicine Unit of a major tertiary hospital. The aim of the study was to describe the safety and effectiveness of partnered medication charting in this setting. A partnered medication review and charting model was developed. Credentialed pharmacists charted pre-admission medications and venous thromboembolism prophylaxis in collaboration with the admitting medical officer. The pharmacist subsequently had a clinical discussion with the treating nurse regarding the medication management plan for the patient. A prospective audit was undertaken of all patients from the initiation of the service. A total of 549 patients had medications charted by a pharmacist from the 14th of November 2012 to the 30th of April 2013. A total of 4765 medications were charted by pharmacists with 7 identified errors, corresponding to an error rate of 1.47 per 1000 medications charted. Partnered medication review and charting by a pharmacist in the Emergency Short Stay and General Medicine unit is achievable, safe and effective. Benefits from the model extend beyond the pharmacist charting the medications, with clinical value added to the admission process through early collaboration with the medical officer. Further research is required to provide evidence to further support this collaborative model. Copyright © 2015. Published by Elsevier Ltd.
    Australasian Emergency Nursing Journal 05/2015; 18(3). DOI:10.1016/j.aenj.2015.03.002
  • Source
    Susan G Poole · J Simon Bell · Michael J Dooley · Carl M Kirkpatrick ·

    European Journal of Clinical Pharmacology 05/2015; 71(7). DOI:10.1007/s00228-015-1851-x · 2.97 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Introduction: It is not known to what extent medication use has been comprehensively assessed in prospective cohort studies of older Australians. Understanding the varying methods to assess medication use is necessary to establish comparability and to understand the opportunities for pharmacoepidemiological analysis. The objective of this review was to compare and contrast how medication-related data have been collected in prospective cohorts of community-dwelling older Australians. Methods: MEDLINE and EMBASE (1990-2014) were systematically searched to identify prospective cohorts of ≥1000 older participants that commenced recruitment after 1990. The data collection tools used to assess medication use in each cohort were independently examined by two investigators using a structured approach. Results: Thirteen eligible cohorts were included. Baseline medication use was assessed in participant self-completed surveys (n = 3), by an investigator inspecting medications brought to a clinic interview (n = 7), and by interviewing participants in their home (n = 3). Five cohorts sought participant consent to access administrative claims data. Six cohorts used multiple methods to assess medication use across one or more study waves. All cohorts assessed medication use at baseline and 12 cohorts in follow-up waves. Twelve cohorts recorded prescription medications by trade or generic name; 12 cohorts recorded medication strength; and 9 recorded the daily medication dose in at least one wave of the cohort. Seven cohorts asked participants about their "current" medication use without providing a definition of "current"; and nine cohorts asked participants to report medication use over recall periods ranging from 1-week to 3-months in at least one wave of the cohort. Sixty-five original publications, that reported the prevalence or outcomes of medication use, in the 13 cohorts were identified (median = 3, range 1-21). Conclusion: There has been considerable variability in the assessment of medication use within and between cohorts. This may limit the comparability of medication data collected in these cohorts.
    PLoS ONE 04/2015; 10(4):e0124247. DOI:10.1371/journal.pone.0124247 · 3.23 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective: The objective of the study was to investigate the prevalence of, and factors associated with, polypharmacy in long-term care facilities (LTCFs). Methods: MEDLINE, EMBASE, International Pharmaceutical Abstracts, Cumulative Index to Nursing and Allied Health Literature, and the Cochrane Library were searched from January 2000 to September 2014. Primary research studies in English were eligible for inclusion if they fulfilled the following criteria: (1) polypharmacy was quantitatively defined, (2) the prevalence of polypharmacy was reported or could be extracted from tables or figures, and (3) the study was conducted in a LTCF. Methodological quality was assessed using an adapted version of the Joanna Briggs Institute Critical Appraisal Checklist. Results: Forty-four studies met the inclusion criteria and were included. Polypharmacy was most often defined as 5 or more (n = 11 studies), 9 (n = 13), or 10 (n = 11) medications. Prevalence varied widely between studies, with up to 91%, 74%, and 65% of residents taking more than 5, 9, and 10 medications, respectively. Seven studies performed multivariate analyses for factors associated with polypharmacy. Positive associations were found for recent hospital discharge (n = 2 studies), number of prescribers (n = 2), and comorbidity including circulatory diseases (n = 3), endocrine and metabolic disorders (n = 3), and neurological motor dysfunctioning (n = 3). Older age (n = 5), cognitive impairment (n = 3), disability in activities of daily living (n = 3), and length of stay in the LTCF (n = 3) were inversely associated with polypharmacy. Conclusions: The prevalence of polypharmacy in LTCFs is high, varying widely between facilities, geographical locations and the definitions used. Greater use of multivariate analysis to investigate factors associated with polypharmacy across a range of settings is required. Longitudinal research is needed to explore how polypharmacy has evolved over time.
    Journal of the American Medical Directors Association 04/2015; 16(6). DOI:10.1016/j.jamda.2015.03.003 · 4.94 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective Understanding smokers’ quit experiences and their preferences for a future quit attempt may aid in the development of effective cessation treatments. The aims of this study were to measure tobacco use behaviour; previous quit attempts and outcomes; methods used to assist quitting; difficulties experienced during previous attempts; the motives and preferred methods to assist quitting in a future attempt; identify the factors associated with preferences for smoking cessation. Design Face-to-face interview using a structured questionnaire. Setting Inpatient wards of three Australian public hospitals. Participants Hospitalised smokers enrolled in a smoking cessation trial. Results Of 600 enrolled patients (42.8% participation rate), 64.3% (n=386) had attempted quitting in the previous 12 months. On a scale of 1 (low) to 10 (high), current motivation to quit smoking was high (median 9; IQR 6.5–10), but confidence was modest (median 5; IQR 3–8). Among 386 participants who reported past quit attempts, 69.9% (n=270) had used at least one cessation aid to assist quitting. Nicotine replacement therapy (NRT) was most commonly stated (222, 57.5%), although the majority had used NRT for <4 weeks. Hypnotherapy was the most common (68, 17.6%) non-pharmacological treatment. Over 80% (n=311) experienced withdrawal symptoms; craving and irritability were commonly reported. Most participants (351, 58.5%) believed medications, especially NRT (322, 53.7%), would assist them to quit in the future. History of previous smoking cessation medication use was the only independent predictor of interest in using medications for a future quit attempt. Conclusions The majority of smokers had attempted quitting in the previous 12 months; NRT was a popular cessation treatment, although it was not used as recommended by most. This suggests a need for assistance in the selection and optimal use of cessation aids for hospitalised smokers. Trial registration number Australian and New Zealand Clinical Trials Registry: ACTRN12612000368831.
    BMJ Open 04/2015; 5(4):e006959-e006959. DOI:10.1136/bmjopen-2014-006959 · 2.27 Impact Factor

  • Asia-Pacific Journal of Clinical Oncology 12/2014; 10:202-202. · 1.54 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Purpose Prospective surveillance of invasive mold diseases (IMDs) in haematology patients should be standard of care but is hampered by the absence of a reliable laboratory prompt and the difficulty of manual surveillance. We used a high throughput technology, natural language processing (NLP), to develop a classifier based on machine learning techniques to screen computed tomography (CT) reports supportive for IMDs. Patients and Methods We conducted a retrospective case-control study of CT reports from the clinical encounter and up to 12-weeks after, from a random subset of 79 of 270 case patients with 33 probable/proven IMDs by international definitions, and 68 of 257 uninfected-control patients identified from 3 tertiary haematology centres. The classifier was trained and tested on a reference standard of 449 physician annotated reports including a development subset (n = 366), from a total of 1880 reports, using 10-fold cross validation, comparing binary and probabilistic predictions to the reference standard to generate sensitivity, specificity and area under the receiver-operating-curve (ROC). Results For the development subset, sensitivity/specificity was 91% (95%CI 86% to 94%)/79% (95%CI 71% to 84%) and ROC area was 0.92 (95%CI 89% to 94%). Of 25 (5.6%) missed notifications, only 4 (0.9%) reports were regarded as clinically significant. Conclusion CT reports are a readily available and timely resource that may be exploited by NLP to facilitate continuous prospective IMD surveillance with translational benefits beyond surveillance alone.
    PLoS ONE 09/2014; 9(9):e107797. DOI:10.1371/journal.pone.0107797 · 3.23 Impact Factor
  • Ruth Chieng · John Coutsouvelis · Susan Poole · Michael J. Dooley · Diana Booth ·
    [Show abstract] [Hide abstract]
    ABSTRACT: Allogeneic stem cell transplantation (SCT) is a complex procedure that requires specialized medication management. Providing clinical pharmacy services in the ambulatory setting is warranted, as medications are a common source of confusion for SCT patients and their carers. These patients were routinely managed via traditional ambulatory dispensary services. The successful implementation of a clinical pharmacy service to the SCT unit ambulatory clinic allowed for regular contact and review by an experienced clinical pharmacist. This new service was evaluated within the context of a research project. The clinical pharmacist's presence in the ambulatory setting resulted in the identification and rectification of many medium to high risk medication related problems. The clinical pharmacist also contributed towards improved overall adherence. Other institutions are encouraged to implement and evaluate clinical pharmacy services to their ambulatory settings for SCT and other complex chronic patients.
    09/2014; 44(3). DOI:10.1002/jppr.1012
  • Erica Y Tong · Melanie Kowalski · Gary S Yip · Michael J Dooley ·

    The Medical journal of Australia 04/2014; 200(6):345-6. DOI:10.5694/mja13.11361 · 4.09 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The purpose of this study was to define the pulmonary and systemic pharmacokinetics of colistin methanesulfonate (CMS) and formed colistin following intravenous (IV) and inhalation administration in cystic fibrosis (CF) patients. Six CF subjects were administered nebulized CMS doses of 2 and 4 million international units (IU) and IV CMS infusion of 150 mg of colistin base activity. Plasma, sputum and urine samples were collected for 12 to 24 h post-dose. To assess tolerability, lung function tests, serum creatinine concentrations and adverse effect reports were undertaken. All doses were well tolerated in subjects. The pharmacokinetic parameters for CMS following IV delivery were consistent with previously reported values. Sputum concentrations of formed colistin were maintained below 1.0 mg/L for 12 h post-dose. Nebulization of CMS resulted in relatively high sputum concentrations of CMS and formed colistin when compared to IV administration. The systemic availability of CMS was low following nebulization of 2 and 4 million IU (7.93 ± 4.26% and 5.37 ± 1.36%, respectively) and plasma colistin concentrations were below the limit of quantification. Less than 2 - 3% of the nebulized CMS dose was recovered in urine in 24 h. The therapeutic availability and drug targeting index for CMS and colistin following inhalation when compared to IV delivery were significantly greater than one. Inhalation of CMS is an effective means of targeting CMS and formed colistin into the lungs as high lung exposure and minimal systemic exposure were achieved in CF subjects.
    Antimicrobial Agents and Chemotherapy 02/2014; 58(5). DOI:10.1128/AAC.01705-13 · 4.48 Impact Factor
  • B. Levkovich · T. Bui · A. Bovell · J. Watterson · A. Egan · S. Poole · M. Dooley ·

    Australian Critical Care 02/2014; 27(1):48–49. DOI:10.1016/j.aucc.2013.10.019 · 1.56 Impact Factor
  • M. J. Dooley · J. McGuiness · S. Choo · E. Tong · K. Neave · S. Poole ·

    International Journal of Clinical Pharmacy 10/2013; 35(5):883-883. · 1.35 Impact Factor
  • M. J. Dooley · E. Dean · J. McGuiness · K. Corben ·

    International Journal of Clinical Pharmacy 10/2013; 35(5):880-881. · 1.35 Impact Factor
  • Ruth Chieng · John Coutsouvelis · Susan Poole · Michael J Dooley · Diana Booth · Andrew Wei ·
    [Show abstract] [Hide abstract]
    ABSTRACT: Patients having undergone allogeneic stem cell transplantation (SCT) require complex medication regimens. To ensure the safe and effective management of this patient group, specialised care in a centre with a dedicated and experienced healthcare team is essential. The aim of this study was to evaluate the effectiveness of a specialty clinical pharmacist working in an ambulatory SCT clinic. A prospective cohort study was conducted on patients post SCT and discharged to the ambulatory setting. Patients were reviewed by a clinical pharmacist weekly for six visits. At these visits a medication review was undertaken. Interventions from these reviews were recorded. Interventions were then assigned a risk rating by a multidisciplinary panel. Adherence was also assessed by a Morisky questionnaire and review of dose administration aids. Comparison of data over the six-visit period was undertaken. In total 23 patients were enrolled in the study. All six visits were completed in 17 patients and 161 interventions were recorded at an average of 1.4 interventions per patient visit. The panel rated 40 % of interventions as high risk, 46 % as medium risk and 14 % as low risk. At all visit points high- and medium-risk interventions constituted >80 % of the total. Morisky scores improved by an average of 1.53 (p < 0.0001) between visits 1 and 6. All patients were scored as highly adherent by visit 6. A specialist clinical pharmacist in the SCT outpatient clinic resulted in regular and effective intervention contributing to improved medication management and adherence.
    Supportive Care in Cancer 08/2013; 21(12). DOI:10.1007/s00520-013-1938-9 · 2.36 Impact Factor
  • Source
    M J Dooley · S G Poole · D Rischin ·
    [Show abstract] [Hide abstract]
    ABSTRACT: Oncology clinicians are now routinely provided with an estimated glomerular filtration rate on pathology reports whenever serum creatinine is requested. The utility of using this for the dose determination of renally excreted drugs compared with other existing methods is needed to inform practice. Renal function was determined by [Tc(99m)]DTPA clearance in adult patients presenting for chemotherapy. Renal function was calculated using the 4-variable Modification of Diet in Renal Disease (4v-MDRD), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), Cockcroft and Gault (CG), Wright and Martin formulae. Doses for renal excreted cytotoxic drugs, including carboplatin, were calculated. The concordance of the renal function estimates according to the CKD classification with measured Tc(99m)DPTA clearance in 455 adults (median age 64.0 years: range 17-87 years) for the 4v-MDRD, CKD-EPI, CG, Martin and Wright formulae was 47.7%, 56.3%, 46.2%, 56.5% and 60.2%, respectively. Concordance for chemotherapy dose for these formulae was 89.0%, 89.5%, 85.1%, 89.9% and 89.9%, respectively. Concordance for carboplatin dose specifically was 66.4%, 71.4%, 64.0%, 73.8% and 73.2%. All bedside formulae provide similar levels of concordance in dosage selection for the renal excreted chemotherapy drugs when compared with the use of a direct measure of renal function.
    Annals of Oncology 08/2013; 24(11). DOI:10.1093/annonc/mdt300 · 7.04 Impact Factor
  • Source
    Basia O Diug · Judy A Lowthian · Michael Dooley ·

    The Medical journal of Australia 08/2013; 199(3):156-8. DOI:10.5694/mja12.11863 · 4.09 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Intensive smoking cessation interventions initiated during hospitalisation are effective, but currently not widely available. Strategies are needed to integrate smoking cessation treatment into routine inpatient care. Pharmacist-led interventions for smoking cessation are feasible and efficacious in both ambulatory and community pharmacy settings. However, there is a lack of evidence from large scale studies of the effectiveness of pharmacist guided programs initiated during patient hospitalisation in achieving long-term abstinence. This study aims to evaluate the effectiveness of a pharmacist-led system change intervention initiated during hospitalisation in Australian public hospitals. A multi-centre, randomised controlled trial will be conducted with 12 months follow-up. Smokers, 18 years or older, will be recruited from the wards of three Victorian public hospitals. Participants will be randomly assigned to a usual care or intervention group using a computer generated randomisation list. The intervention group will receive at least three smoking cessation support sessions by a trained pharmacist: the first during the hospital stay, the second on or immediately after discharge and the third within one month post-discharge. All smoking cessation medications will be provided free of charge during the hospital stay and for at least one week after discharge. Participants randomised to usual care will receive the current care routinely provided by the hospital. All measurements at baseline, discharge, one, six and 12 months will be performed by a blinded Research Assistant. The primary outcome measures are carbon monoxide validated 7-day point prevalence abstinence at six and 12 months. This is the first large scale study to develop and test a pharmacist-led system change intervention program initiated during patient hospitalisation. If successful, the program could be considered for wider implementation across other hospitals. Trial registration ACTRN12612000368831
    Trials 05/2013; 14(1):148. DOI:10.1186/1745-6215-14-148 · 1.73 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Antimicrobial stewardship programs are recommended to reduce antimicrobial resistance by reducing inappropriate use of antimicrobials. We implemented an antimicrobial stewardship program and aimed to evaluate its effect on broad-spectrum antimicrobial use. Observational study with historical control using interrupted time series analysis conducted in a tertiary referral hospital. Hospital inpatients prescribed restricted antimicrobials for non-standard indications, where approval had expired or without approval. Baseline period of 30 03s immediately followed by an 18-03 intervention period commencing January 2011. Number and type of interventions made by antimicrobial stewardship team; 03ly rate of use of broad-spectrum antimicrobial agents (in defined daily doses/1000 occupied bed-18s). The antimicrobial stewardship team made 1104 recommendations in 779 patients during the 18-03 intervention period. In 64% of cases, the recommendation was made to cease or de-escalate the antimicrobial therapy, or to change from intravenous to oral therapy. The introduction of the intervention resulted in an immediate 17% (95% CI, 13%-20%) reduction in broad-spectrum antimicrobial use in the intensive care unit and a 10% (95% CI, 4%-16%) reduction in broad-spectrum antimicrobial use outside the intensive care unit. Reductions were particularly seen in cephalosporin and glycopeptide use, although these were partially offset by increases in the use ofβ-lactam-β-lactamase inhibitors. The introduction of an antimicrobial stewardship program, including postprescription review, resulted in an immediate reduction in broad-spectrum antimicrobial use in a tertiary referral centre. However, the effect of this intervention reduced over time.
    The Medical journal of Australia 03/2013; 198(5):262-6. DOI:10.5694/mja12.11683 · 4.09 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The practice of naturopathy and Western herbal medicine (WHM) was built on traditional evidence but may be undergoing change with the advent of scientific evidence. The aims of this research were to provide a better understanding of practitioners' attitudes towards evidence, information sources, professional regulation and their knowledge about the evidence of commonly used complementary medicines (CMs). Naturopaths and WHM practitioners were invited to participate in an anonymous, self-administered, on-line survey. Participants were recruited using the mailing lists and websites of CM manufacturers and professional associations. Four hundred and seventy nine practitioners participated; 95% currently in practice. The majority (99%) thought well documented traditional evidence was essential or important, 97% patient reports and feedback, 97% personal experience, 94% controlled randomised trials and 89% published case reports. Significantly more recent graduates (less than 5 years) rated randomised trials as essential compared to others. Most (82%) respondents want information sources containing both traditional and scientific evidence. They currently use several resources; 74% CM textbooks, 67% conferences/seminars, 57% CM journals, 48% databases and 40% manufacturers' information. The mean knowledge score was 61.5% with no significant differences between respondents with diploma or degree level education or by graduating year. Eighty-five percent of practitioners strongly agreed or agreed that practitioners should be formally registered to safeguard the public, 8% were unsure and 8% disagreed or strongly disagreed. Naturopaths and WHM practitioners accept the importance of scientific evidence whilst maintaining the importance and use of traditional evidence. The majority are in favour of professional registration.
    Complementary therapies in medicine 02/2013; 21(1):58-64. DOI:10.1016/j.ctim.2012.11.008 · 1.55 Impact Factor

Publication Stats

699 Citations
241.11 Total Impact Points


  • 2008-2015
    • Alfred Hospital
      • Department of Pharmacy
      Melbourne, Victoria, Australia
    • Monash University (Malaysia)
      Labuan, Labuan, Malaysia
    • Eastern Health Australia
      Box Hill, Victoria, Australia
  • 2004-2015
    • Monash University (Australia)
      • Faculty of Pharmacy and Pharmaceutical Sciences
      Melbourne, Victoria, Australia
  • 2014
    • Melbourne Health
      Melbourne, Victoria, Australia
  • 2005-2014
    • University of Vic
      Vic, Catalonia, Spain
  • 2012
    • Alfred University
      Alfred, New York, United States
  • 2007
    • Institut Paoli Calmettes
      Marsiglia, Provence-Alpes-Côte d'Azur, France
  • 2002-2007
    • Victorian College for the Deaf
      Melbourne, Victoria, Australia
  • 2000-2005
    • Peter MacCallum Cancer Centre
      • Pharmacy Division
      Melbourne, Victoria, Australia