Dr. Esther W.Y. CHAN 陳慧賢
Dr Esther Chan obtained her BPharm(Hons), Master of Clinical Pharmacy, GradCertPharmEc and PhD from Monash University, Australia. She joined the Department of Pharmacology and Pharmacy, HKU in 2012 and was promoted to Associate Professor in 2017. Dr Chan is research lead for the Centre for Safe Medication Practice and Research.
Dr Chan completed her internship and residency training at Austin Hospital (Melbourne) and focused clinical practice and research in the Emergency Department. She also trained in Infectious Diseases at Oxford Radcliffe, NHS Trust, and Trauma and Emergency Care at the University Medical Center (Tucson, Arizona, USA). Alongside clinical work, she taught at undergraduate and postgraduate levels and was Teaching Associate for the internship program at Austin Hospital and Monash University. Dr Chan was appointed Honorary Research Fellow of the Department of Emergency Medicine, Austin Hospital and was the recipient of DBL Hospira Young Pharmacist Award from The Society of Hospital Pharmacists of Australia. In 2013, she was inducted as Fellow of The Society of Hospital Pharmacists of Australia.
Dr Chan’s main research focus is in determining the safety and effectiveness of medicines, and expanding knowledge about the application of drugs in three key areas: medicines used in the management of cardiovascular diseases, including anticoagulants that prevent or reduce the risk of stroke; medicines affecting the gut, and medicines used in mental health. She applies a variety of methodologies utilising innovative Big Data and interventional study designs in her areas of research interest. Dr Chan has led completed and ongoing multi-centre randomised clinical trials comparing sedative and antipsychotic drugs for the management of behavioural emergencies. Her research findings have led to changes in clinical practice guideline on drug recommendations; and improving clinical practice and patient care internationally. Dr Chan’s research has been published in leading journals including JAMA, JAMA Internal Medicine, Journal of the American College of Cardiology, Gastroenterology, Gut and Annals of Emergency Medicine. Her achievements are recognised with awards from funding bodies including the RGC Early Career Scheme (2013) and The National Natural Science Fund (NSFC) - Young Scientist Fund (2018). Dr Chan received the Faculty of Medicine Outstanding Research Output Award in three consecutive years (2016-2018); and was recipient of the Outstanding Young Researcher Award in 2018.
Dr Chan strives to achieve an enriching nexus between teaching and research, further advance medication safety, and through translating new knowledge into captivating educational materials, inspire students towards better clinical practice and ultimately, improve patient care. Dr Chan received the Faculty of Medicine Teaching Medal 2018 in recognition of her outstanding performance in teaching and promotion of good teaching practice.
- Fellow, Society of Hospital Pharmacists of Australia (SHPA, Australia)
- Registered Pharmacist, Australian Health Practitioner Regulation Agency (AHPRA, Australia)
- Registered Pharmacist, General Pharmaceutical Council (GPC, UK)
- Member, Research Centre of Heart, Brain, Hormone & Healthy Aging, HKU
- Member, International Society of Pharmacovigilance (ISOP)
- Member, The Pharmaceutical Society of Hong Kong (PSHK, Hong Kong)
- Member, International Society for Pharmacoeconomics and Outcomes Research (ISPOR)
- Member, SHPA Committee of Specialty Practice (COSP): Emergency Medicine, Infectious Diseases
Honours and Awards
- Outstanding Young Researcher Award, The University of Hong Kong; 2018
- Faculty Teaching Medal, Faculty of Medicine, The University of Hong Kong; 2018
- Best Original Paper Award, Hong Kong Medical Journal, Hong Kong Academy of Medicine; 2017
- Faculty Outstanding Research Output Award, Faculty of Medicine, The University of Hong Kong; 2016 (as first-author), 2017 (as corresponding author) and 2018 (as co-author)
- Incentive award for successful RGC/GRF Funding, The University of Hong Kong; 2014-2015
- Fellowship, Society of Hospital Pharmacists of Australia (SHPA); 2013
- DBL Hospira Young Pharmacist Award, SHPA; 2009
- Ian Scott PhD Scholarship, Australian Rotary Health; 2008-2010
- Academic Prize; top candidate, Master of Clinical Pharmacy, Monash University, Australia; 2007
- Big data research: pharmacoepidemiology and medication safety
- Prospective clinical study design; clinical and practice-based research
- Behavioural emergencies and mental health
- Pharmacoeconomics analyses; decision-analytic models, budget impact studies, willingness-to-pay
- Pharmacy practice and service development
Law SWY, Lau WCY, Wong ICK, Lip GYH, Mok MT, Siu CW, Chan EW.
Sex-based differences in outcomes of oral anticoagulation in patients with atrial fibrillation. J Am Coll Cardiol,2018; 72(3): 271-282. Click to see abstract ; paper
Impact Factor (2017): 16.834, (Rank: 3/128 Cardiac & Cardiovascular Systems), 5-year Impact Factor: 18.737
(The University of Hong Kong) 19 November, 2018
Strategic partnership on medication safety using big data, The University of Hong Kong and UCL
(The University of Hong Kong) 19 November, 2018
Using big data to reduce the risk of stroke, The University of Hong Kong and UCL
This study compared the effectiveness and safety outcomes of direct oral anticoagulants (DOACs) versus warfarin in men and women with stratifications for anticoagulation control. DOACs were found to be associated with a lower risk of intracranial hemorrhage [ICH] and all-cause mortality in women only, where the association of lower ICH risk remained when compared with warfarin users with good anticoagulation control.
Of 4,972 men and 4,834 women successfully matched in our cohort, compared with warfarin, DOAC use was associated with a lower risk of ICH (hazard ratio [HR]: 0.16; 95% confidence interval [CI]: 0.06 to 0.40) and all-cause mortality (HR: 0.55; 95% CI: 0.39 to 0.77) in women but not in men. The treatment by sex interaction was significant for ICH only, and a significantly lower risk of ICH remained in the DOAC group when compared with warfarin users with good anticoagulation control (HR: 0.13; 95% CI: 0.02 to 1.00) among women only. The risks of ischemic stroke or systemic embolism and gastrointestinal bleeding with DOACs versus warfarin were comparable in both sexes.
Lau WCY, Chan EW, Cheung CL, Sing CW, Man KKC, Lip GYH, Siu CW, Lam JKY, Lee ACH, Wong ICK.
Association between dabigatran vs warfarin and risk of osteoporotic fracture among patients with nonvalvular atrial fibrillation. JAMA. 2017; 317(11):1151-1158. Click to see abstract
Impact Factor (2017): 47.661, (Rank: 3/155 Medicine, General & Internal), 5-year Impact Factor: 42.464.
(香港電臺) 11 April 2017
(東網) 11 April 2017
(The University of Hong Kong) 11 April 2017
HKU discovers that traditional blood thinner drug is associated with a higher risk of osteoporotic fracture compared to newer drug
This paper was selected for press conference held on 11th April 2017 at The University of Hong Kong and the research findings were disseminated through over 20 media sources.
The risk of osteoporotic fracture with dabigatran use in patients with nonvalvular atrial fibrillation (NVAF) is unknown. The aim of our study was to investigate the risk of osteoporotic fractures with dabigatran vs warfarin in patients with NVAF. We performed a retrospective cohort study using a population-wide database managed by Hong Kong Hospital Authority. Patients newly diagnosed with NVAF from 2010 through 2014 and prescribed dabigatran or warfarin were matched by propensity score at a 1:2 ratio with follow-up until July 31, 2016. Risk of osteoporotic hip fracture and vertebral fracture was compared between dabigatran and warfarin users using Poisson regression. The corresponding incidence rate ratio (IRR) and absolute risk difference (ARD) with 95% CIs were calculated. Results of Poisson regression analysis showed that dabigatran use was associated with a significantly lower risk of osteoporotic fracture compared with warfarin. The association with lower risk was statistically significant in patients with a history of falls, fractures, or both (dabigatran vs warfarin, but not in those without a history.
Cheung KS, Chan EW, Wong AY, Chen L, Wong ICK, Leung WK.
Long-term proton pump inhibitors and risk of gastric cancer development after treatment for H. pylori: A population-based study. Gut. 2018; 67:28-35. doi: 10.1136/gutjnl-2017-314605. Click to see abstract
Impact Factor (2017): 17.016, (Rank: 3/80 Gastroenterology & Hepatology), 5-year Impact Factor: 15.910.
(頭條日報) 14 November 2017
(星島日報) 14 November 2017
(The University of Hong Kong) 13 November 2017
HKU Finds that Long-term Use of Proton Pump Inhibitors is Associated with an Increased Risk of Stomach Cancer
Although Helicobacter pylori eradication has been shown to reduce the risk of gastric cancer development, a considerable proportion of these individuals continues to progress to gastric cancer even after successful eradication of H. pylori. This study investigated the association between PPIs use and gastric cancer (GC) among H. pylori-infected subjects who had received HP therapy. The results showed that long-term PPIs use was associated with a 2.4-fold increase in gastric cancer risk in H. pylori-infected subjects who had received eradication therapy, and that the risk of gastric cancer increased with the dose and duration of PPIs use.
This work was awarded the Faculty of Medicine Outstanding Research Output Award 2018.
Wong AYS, Wong ICK, Chui CSL, Lee EHM, Chang WC, Chen EYH, Leung WK, Chan EW.
Association between acute neuropsychiatric events and Helicobacter pylori therapy containing Clarithromycin. JAMA Intern Med. 2016; 176(6):828-834. Click to see abstract
Impact Factor (2017): 19.989, (Rank: 5/155 Medicine, General & Internal), 5-year Impact Factor: 17.840.
Clarithromycin is used for the treatment of respiratory infections, including community-acquired pneumonia. It is also commonly prescribed in combination with amoxicillin or metronidazole, plus proton pump inhibitors (PPIs) as a first-line standard treatment for Helicobacter pylori eradication. Among potential adverse events associated with the use of clarithromycin, neuropsychiatric symptoms in patients with or without other long-term comorbidities, such as renal disease, hypertension, and obstructive airway disease remains a concern. Apart from clarithromycin monotherapy, neuropsychiatric symptoms were also observed in patients receiving H pylori therapy containing clarithromycin. This study investigated the association between H pylori therapy containing clarithromycin and acute neuropsychiatric events. The results showed that there is evidence of a short-term increased risk of neuropsychiatric events associated with H pylori therapy containing clarithromycin, which will usually resolve after cessation of treatment and psychiatric intervention can be avoided.
This work was awarded the Faculty of Medicine Outstanding Research Output Award 2017.
Chan EW, Lau WCY, Leung WK, Mok MTC, He Y, Tong TSM, Wong ICK.
Prevention of dabigatran --related gastrointestinal bleeding with gastroprotective agents: A population-based study. Gastroenterology 2015;149(3):586-595.e3. Click to see abstract
Impact factor (2017): 20.773, (Rank 1/80; Gastroenterology & Hepatology), 5-year impact factor: 19.131.
The use of dabigatran, an inhibitor of thrombin, increases risk of gastro intestinal bleeding (GIB). However, it is not clear whether gastroprotective agents (GPA’s) prevent GIB in dabigatran users. This study investigated the risk of GIB and the role of GPA’s (including proton pump inhibitors and histamine type-2 receptor antagonists) in patients using dabigatran. This study showed that in the Hong Kong population, the use of GPAs was associated with a reduced risk of GIB in patient taking dabigatran. The association was stronger for upper GIB than lower GIB, and in patients with prior history of peptic ulcer or GIB.
This work was awarded the Faculty of Medicine Outstanding Research Output Award 2016.
Chan EW, Taylor DMcD, Knott JC, Phillips GA, Castle DJ, Kong DCM.
Intravenous droperidol or olanzapine as an adjuncts to midazolam for the acutely agitated patient: A multi-centre, randomised, double-blind, placebo-controlled clinical trial. Ann Emerg Med. 2013; 61(1):72-81. Click to see abstract
Impact Factor (2017): 5.008 (Rank: 2/26; Emergency Medicine), 5-year Impact Factor: 5.441.
This multicentre clinical randomised controlled trial was the first rigorous study to compare two IV drug combinations (droperidol and midazolam or olanzapine and midazolam) with a commonly used control (midazolam alone) regimen. This study provided the first evidence that olanzapine by intravenous (IV) administration may be a useful and safe option for the management of acute agitation. Both combinations produced significantly more rapid and effective sedative with similar safety profile. Droperidol remains a safe and effective drug for sedation despite concerns following the FDA black-box warning. Subsequent to publication of this paper, IV olanzapine was added to the Australian Therapeutic Guideline 2013 as an option for the management of behavioural emergencies. This paper was the feature article, selected for media release in Sept 2012 by American College of Emergency Physicians, Reuters, and Monash University. This article was among the top 25 downloads via ScienceDirect in 2013.
- Blais JE, Chan EW, Law SWY, Mok MT, Huang D, Wong ICK, Siu CW. Trends in statin prescription prevalence, initiation, and dosing: Hong Kong, 2004–2015. Atherosclerosis; Jan, 2019; 280: 174–182. Click to see abstract
- Taylor DMcD, Yap C, Knott JC, Phillips GA, Karro J, Taylor SE, Chan EW, Castle, DC, Kong DCM. Midazolam-droperidol, droperidol or olanzapine for acute agitation: a randomised clinical trial. Ann Emerg Med 2017; 69(3):318-326.e1. Click to see abstract
- Lau WCY, Li X, Wong ICK, Man KKC, Lip GYH, Leung WK, Siu CW, Chan EW. Bleeding-related hospital admissions and 30-day readmissions in patients with non-valvular atrial fibrillation treated with dabigatran versus warfarin. J Thromb Haemost 2017; 15(10): 1923-1933. Click to see abstract
- Wong AYS, Chan EW, Anand S, Worsley A, Wong ICK. Managing cardiovascular risk of macrolides: systematic review and meta-analysis. Drug Saf 2016; 40(8):663-677. Doi:10.1007/s40264-017-0533-2. Click to see abstract
- Chan EW, Lau WCY, Siu CW, Lip GYH, Leung WK, Anand S, Man KKC, Wong ICK. Effect of suboptimal anticoagulation treatment with antiplatelet therapy and warfarin on clinical outcomes in patients with non-valvular atrial fibrillation: A population-wide cohort study. Heart Rhythm 2016; 13(8):1581-1588. Click to see abstract
- Lao KSL, He Y, Wong ICK, Besag FMC, Chan EW. Tolerability and safety profile of cariprazine in treating psychotic disorder, bipolar disorder and major depressive disorder: a systematic review with meta-analysis of randomised controlled trials. CNS Drugs. 2016, 30(11):1043-1054. Click to see abstract
- Wong AYS, Root A, Douglas I, Chui CSL, Chan EW, Ghebremichael-Weldeselassie Y, Siu CW, Smeeth L, Wong ICK. Cardiovascular outcomes associated with use of clarithromycin: population based study. BMJ 2016; 352:h6926. doi: 10.1136/bmj.h6926. Click to see abstract
- Wong AYS, Chan EW, Anand S, Worsley A, Wong ICK. Managing cardiovascular risk of macrolides: systematic review and meta-analysis. Drug Saf 2017, 40: 663-677. doi:10.1007/s40264-017-0533-2. Click to see abstract
- Li X, Tse VC, Au-Doung LW, Wong ICK, Chan EW. The impact of ischaemic stroke on atrial fibrillation-related healthcare cost: a systematic review. Europace 2017; Jun 1;19(6):937-947. doi: 10.1093/europace/euw093. Click to see abstract
- Li X, Tse VC, Lau WCY, Cheung BMY, Lip GYH, Wong ICK, Chan EWY. Cost-effectiveness of apixaban versus warfarin in Chinese patients with non-valvular atrial fibrillation: a real-life and modelling analysis. Plos ONE 2016; 11(6):e0157129 (15 pages). Click to see abstract
Dr. Chan has received funding and support from:
- National Natural Science Fund of China (NSFC) – Young Scientist Fund, China
- Research Grants Council (Early Career Scheme, General Research Fund), Hong Kong
- Narcotics Division, Security Bureau, Beat Drugs Fund Regular Funding Scheme, Hong Kong
- The University of Hong Kong (Small Projects Grants, Seed Funding Scheme), Hong Kong
- Health and Medical Research Fund (HMRF), Hong Kong
- National Health and Medical Council (NHMRC), Australia
- Australian Rotary Health, Australia
- Pharmaceutical Industry Sponsors
Selected Grants and Funding:
- National Natural Science Fund of China (NSFC) – Young Scientist Fund; (2018 – 2020) “Preferences and willingness to pay for novel oral anticoagulants in patients with atrial fibrillation in China” (71704149) – Principal Investigator.
- Beat Drugs Fund Regular Funding Scheme (BDF); (2017 – 2019) “Understanding drug abusers and their healthcare pathways: towards better management in Hong Kong” (BDF160052) – Principal Investigator.
- Research Grants Council, General Research Fund (GRF); (2016 – 2018) “Oro-dispersible olanzapine (wafer) versus conventional oral haloperidol or diazepam tablets for the management of acute agitation in the Accident and Emergency Department – a multicentre randomised clinical trial” (17111615) – Principal Investigator.
- Research Grants Council, General Research Fund (GRF); (2015) “Pharmacoepidemiology of oral anticoagulation agents – a comparison of dabigatran etexilate, warfarin and dual-antiplatelet therapy in patients with atrial fibrillation” (17102314) – Principal Investigator.
- Research Grant Council, Early Career Scheme (ECS); (2014 – 2017) “Intramuscular olanzapine versus haloperidol or midazolam for the management of acute agitation in the emergency department-a multicenter randomized clinical trial” (789813) – Principal Investigator.
- Health and Medical Research Fund (HMRF); (2014 – 2016) “Measuring the burden of fatal and nonfatal injury in Hong Kong” (11121401) – Co-Investigator.
- Health and Medical Research Fund (HMRF); (2014 – 2016) “Mother’s preferences and willingness to pay for human papillomavirus vaccination for their daughters: a discrete choice experiment in Hong Kong” (13120652) – Principal Investigator.
- National Health and Medical Research Council (NHMRC, Australian Government); (2009 – 2011) “Droperidol and olanzapine as adjuncts to midazolam for the acutely agitated patient: a randomised clinical trial” (628501) – Associate Investigator A.
Seeking full time PhD candidates and Research Assistants commencing 2019-2020
We are seeking highly organised and motivated registered practitioners in nursing, pharmacy, medicine or related disciplines to conduct research in the areas of clinical trials, medication safety, pharmacoepidemiology and pharmacoeconomics. We are also seeking Research Assistants who have knowledge of data analysis and presentation and capability to work independently. Experience in working with large data sets, programming and pharmacoeconomic models will be an advantage.
For further information please email Dr. Esther Chan with your research proposal and CV ([email protected]).
Undergraduate training for Randomised Clinical Trials (RCTs) 2019-2020
We provide training to undergraduate students to participate in multicentre randomised clinical trials in Hong Kong, as summer research experience or overseas research exchange. The training period will be a minimum of two months. Students will receive training in RCT study design, trial project management, patient screening, and use of clinical assessment scales. Students in pharmacy, nursing, medicine or related disciplines who wish to enhance research skills or gain clinical exposure in the Accident & Emergency department and ward settings are encouraged to apply. For application and enquiries, please email Dr. Esther Chan with CV at [email protected]
Current Team Members and Students
- Ms Chan, Adrienne (Research Assistant)
- Ms Ge, Grace (Research Assistant)
- Ms Lam, Lam (Research Assistant)
- Ms Lam, Lisa (Research Assistant)
- Dr Lao, Kim (Research Assistant)
- Dr Li, Shirley (Post-Doctoral Fellow)
- Ms Shami, Jessica (Research Assistant)
- Dr Pathadka, Swathi (Research Assistant)
- Dr Suh, Jenny (Research Assistant)
- Ms Wei, Luna (Research Assistant)
- Mr Zhao, Jesse (Research Assistant)
- Doctor of Philosophy (PhD)
- As primary supervisor
- Blais, Joseph (2018-)
- Lao, Shi Jian Kim (2014-2018)
- Lau, Cheuk Yin Wallis (2013-2017)
- Wong, Yun Sum Angel (2013-2017)
- Chui, Sze Ling Celine (2013-2017)
- He, Ying Helen (2012-2015)
- As co-supervisor
- Ng, Wai Sei, Vanessa (2019- )
- Master of Philosophy (MPhil)
- Wong, Kai Chung Vincent (2015-2018)
- Department of Geriatric Cardiology, the Second Medical Centre, Chinese PLA General Hospital, Beijing, China
- The Asian Pharmacoepidemiology Network (AsPEN)
- Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia
- Hong Kong Poison Information Centre
- Department of Accident and Emergency; North District Hospital, Pamela Youde Nethersole Eastern Hospital, Prince of Wales Hospital, Queen Elizabeth Hospital, Queen Mary Hospital, Ruttonjee Hospital, Tuen Mun Hospital, United Christian Hospital, Hospital Authority, Hong Kong
- Emergency and General Medicine Research, Department of Emergency Medicine, Austin Hospital; Department of Emergency Services, Royal Melbourne Hospital; St. Vincent's Hospital Melbourne Victoria, Australia
- Department of Medicine (Clinical Pharmacology, Endocrinology and Metabolism, Gastroenterology & Hepatology; Psychiatry; Respiratory Medicine), LKS Faculty of Medicine, HKU; Queen Mary Hospital, Hong Kong
- Department of Microbiology, Department of Pharmacy, Queen Mary Hospital, Hong Kong
- Department of Psychiatry, St. Vincent's Hospital Melbourne, Victoria, Australia
- School of Nursing, LKS Faculty of Medicine, HKU
Centre for Safe Medication Practice and Research
Web site: CSMPR
1/F, Jockey Club Building for Interdisciplinary Research
5 Sassoon Road, Pokfulam
Hong Kong SAR, China
For appointments email: [email protected]
Regular Student Consultation HoursEvery Tuesday at 2:00pm - 3:00pm
Department of Pharmacology and Pharmacy
Li Ka Shing Faculty of Medicine
02-08, 2/F Laboratory Block, 21 Sassoon Road, Pokfulam
Hong Kong SAR, China
Email: [email protected]