Dr. Esther Wai Yin Chan
Associate Professor
Dr. Esther Wai Yin Chan
Department of Pharmacology and Pharmacy
The University of Hong Kong
HKU Hubs
Dr. Esther Chan and her research associates
Dr. Esther Chan and her research associates

Associate Professor

Dr. Esther Wai Yin Chan (陳慧賢)
BPharm(Hons), MClinPharm, GradCertPharmEc, PhD Monash Au, FSHP


  • 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
  • Member, Golden Key International Honour Society


Following the completion of her Bachelor of Pharmacy, Dr Esther Chan completed her internship and residency training at Austin Health (Melbourne, Australia). Dr Chan completed her Master of Clinical Pharmacy at Monash University, while she continued clinical practice and research in the Austin Emergency Department. Alongside clinical work, she was a Teaching Associate at Monash University and was involved in undergraduate and postgraduate teaching; and internship training. In 2007, Dr Chan was appointed an Honorary Research Fellow of the Department of Emergency Medicine, Austin Health. Dr Chan received the 2009 DBL Hospira Young Pharmacist Award from The Society of Hospital Pharmacists of Australia, which supported her work in the Emergency Department (ED), University Medical Center (Tucson, Arizona, USA). In 2013, she was inducted as Fellow of The Society of Hospital Pharmacists of Australia.

Dr Chan completed her PhD on the clinical management of acute agitation in the emergency setting involving clinical trial methodology. She joined the Department of Pharmacology and Pharmacy at the University of Hong Kong in January 2012 and is currently research lead for the Centre for Safe Medication Practice and Research. In 2016, Dr Chan received the Faculty of Medicine Outstanding Research Output Award.

My Research Interests

  • Behavioural emergencies and mental health
  • Prospective clinical study design; clinical and practice-based research in the emergency medicine setting
  • Pharmacoeconomics analyses; decision-analytic models, budget impact studies, Willingness-to-pay
  • Pharmacoepidemiology and medication safety
  • Pharmacy practice and service development

Publications Highlights

Lau WCY, Chan EW, Cheung CL, Sing CW, Man KKC, Lip GYH, Siu CW, Lam JKY, Lee ACH, Wong ICK. Risk of osteoporotic fracture with dabigatran versus warfarin in patients with nonvalvular atrial fibrillation. JAMA. 2017; 317(11):1151-1158. Click to see abstract
Impact Factor (2015): 37.684, (Rank: 3/155 Medicine, General & Internal), 5-year Impact Factor: 33.569.

Press conference and selected media releases

(香港電台) 11 April 2017
研究指長期使用傳統薄血藥可致骨折 嚴重或增死亡率

(東網) 11 April 2017
新型薄血藥可減骨折風險 港大倡病人轉用

(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

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.

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 (2015): 14.000, (Rank: 6/151 Medicine, General & Internal), 5-year Impact Factor: 14.063.

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.

Chan EW, Lau WCY, Leung WK, Mok MTC, He Y, Tong TSM, Wong ICK.
Prevention of Dabigatran Related Gastrointestinal Bleeding by Gastroprotective Agents: A Population-Based Retrospective Cohort Study. Gastroenterology 2015;149(3):586-595.e3. Click to see abstract
Impact factor (2015): 18.187, (Rank 1/78; Gastroenterology & Hepatology), 5-year impact factor: 15.417.

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.

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 (2015): 5.008 (Rank: 2/24; Emergency Medicine), 5-year Impact Factor: 5.041.

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 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 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.


Selected Publications

  • Wong AYS, Chan EW, Anand S, Worsley A, Wong ICK. Managing cardiovascular risk of macrolides: systematic review and meta-analysis. Drug Saf. 2017, Printed online ahead of print Doi:10.1007/s40264-017-0533-2. 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
  • 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
  • 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 2016; euw093. Published online ahead of print. 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
  • He Y, Wong ICK, Li X, Anand S, Leung WK, Siu CW, Chan EW. The association between Non-vitamin K antagonist oral anticoagulants and gastrointestinal bleeding: a meta-analysis of observation studies. Br. J. Clin. Pharmacol. 2016; 82(1):285-300. Click to see abstract
  • Chui CSL, Wong ICK, Wong LYL, Chan EW. Association between oral fluoroquinolone use and the development of retinal detachment: a systematic review and meta-analysis of observational studies. J Antimicrob Chemother. 2015; 70(4):971-978. Click to see abstract
  • Chan EW, Tang C, Lao SJ, Leung LP, Tsui SH, Ho HF, Wong G, Kong DCM, Knott JC, Wong ICK. Management of acute agitation in Hong Kong and comparisons with Australasia. Emerg Med Australas. 2015; 27(6):542-548. Click to see abstract
  • Chan EW, Liu KQL, Chui CSL, Wing CW, Wong LYL, Wong ICK. Adverse Drug Reactions – Examples of detection of rare events using databases. Br J Clin Pharmacol. 2014; 80(4):855-861. Click to see abstract


Dr. Chan has received funding and support from:

  • 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:

  • 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.

Honours and Awards

  • Faculty of Medicine Outstanding Research Output Award, The University of Hong Kong; 2016
  • 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


Undergraduate training for Randomised Clinical Trials (RCTs) 2017-2018

We wish to 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 ewchan@hku.hk

Seeking full time PhD candidates and Research Assistants commencing 2017-2018

We are seeking highly organised and motivated registered practitioner in nursing, pharmacy, medicine or related disciplines for 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 (ewchan@hku.hk).

Current Team Members and students

  • Dr Anand, Shweta (Research Assistant)
  • Mr Choi, Rankie (Senior Technical Assistant)
  • Ms Lam, Lam (Research Assistant)
  • Ms Law, Wai Yan Sharon (Research Assistant)
  • Dr Li, Shirley (Post-Doctoral Fellow)
  • Ms Ng, Hoi Lee Kelly (Research Assistant)
  • Dr Tam, Wai Yee Anthony (Research Associate)
  • Doctor of Philosophy (PhD)
    • Lao, Shi Jian Kim (2014-)
    • Lau, Cheuk Yin Wallis (2013-)
    • Chui, Sze Ling Celine (2013-2017)
    • He, Ying Helen (2012-2015)
  • Master of Philosophy (MPhil)
    • Wong, Kai Chung Vincent (2015-)
  • Master of Clinical Pharmacy (MClinPharm)
    • Cheung, Fiona (2016-2017)
    • Poon, Ka Yan (2016-2017)
  • Master of Medical Science (MMedSc)
    • Ning, Chan Sai Nicole (2015-2016)

Research Collaborators

  • 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; Queen Elizabeth Hospital, Queen Mary Hospital, Prince of Wales Hospital, Ruttonjee Hospital, Pamela Youde Nethersole Eastern 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


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: ewchan@hku.hk

Centre for Safe Medication Practice and Research

Web site: http://www.pharma.hku.hk/sweb/CSMPR/

Jockey Club Building for Interdisciplinary Research
1/F, 5 Sassoon Road, Pokfulam
Hong Kong SAR, China
For appointments email: shweta@hku.hk