Thursday, 15 June 2017

Profile: Dr Ingrid Hopper, joint winner of Mollie Holman Medal

Dr Ingrid Hopper in action with participant

Today we congratulate Dr Ingrid Hopper, SPHPM’s second Mollie Holman Medal winner. Ingrid’s PhD was supervised by the late Professor Henry Krum. Of her PhD experience, she says,

“The quality of supervision I received from Henry KrumAndrew Tonkin and Marina Skiba was fantastic and I felt I had the support of the whole school. It was a wonderful experience with an interesting spread of subjects, which is a reflection of the broad program the School offers.”

Ingrid’s research focused on polypharmacy in people with heart failure. Heart failure happens when the heart muscle is damaged and doesn’t pump properly, causing extra fluid to build up in the body. Polypharmacy is when people take five or more prescription drugs to control a condition or multiple conditions.

Multiple drugs are needed to treat heart failure, but these can create unwanted effects. The number of side effects increases with the number of drugs, which may be a result of the drugs interacting.

From a practical perspective, the more drugs prescribed, the less likely people are to take them all correctly. It’s difficult to remember dosages and timings, and it can be costly.

Ingrid’s background in clinical pharmacology first sparked her interest in this topic. She says,

“Clinical pharmacology is the science of drugs and their clinical use. It focuses on safe use of medicine, maximising the effects of drugs while minimising side effects. Patients with heart failure are usually elderly, with multiple medical conditions, needing many medications. Medications can contribute to devastating events such as falls and delirium, so minimising the number of unnecessary medications taken by the elderly is crucial.”

For her PhD, Ingrid investigated withdrawing three classes of drugs used in heart failure which were potentially unnecessary. Exciting and unexpected results came from her studies of digoxin.

“Digoxin was isolated from the foxglove plant over 200 years ago, and has been used since then for heart failure. We hypothesised that there was no longer a role for this drug in modern day heart failure treatment, as other far more powerful drugs such as beta-blockers and ACE inhibitors have been shown to be effective.”

Ingrid found that even with optimal therapy using modern heart failure drugs, digoxin still has a role to play in controlling symptoms. No current patents exist for digoxin, making it cheap and plentiful.

Ingrid also investigated patient attitudes to medications.

“In similar studies done previously, up to 90% of patients said they would be happy to stop a medication if their doctor said they could. This was much lower in the patients with heart failure I surveyed. Despite taking an average of eight medications daily, they were generally satisfied with taking that many.”

These days Ingrid is the Project Lead for the Australian Breast Device Registry, based at SPHPM. She says,

“This role sees me managing surveillance data regarding breast implants and similar devices. Gathering and analysing outcomes data will help us identify best practice and risks around breast devices for people using them for cosmetic or reconstructive reasons.”

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