Prescribing deprescribing for polypharmacy in Aotearoa New Zealand; experiences of a medication review activity in final year medical students on a general practice module

Samantha A. Murton; Lynn McBain; Caroline Morris; Estelle Jaine; Lesley Gray

doi:10.1071/HC23169

RESEARCH ARTICLE (Open Access)

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Prescribing deprescribing for polypharmacy in Aotearoa New Zealand; experiences of a medication review activity in final year medical students on a general practice module

Samantha A. Murton

¹ ^* , Lynn McBain

¹ , Caroline Morris

¹ , Estelle Jaine ¹ , Lesley Gray

¹

+ Author Affiliations

- Author Affiliations

¹ University of Otago, Wellington, Department of Primary Health Care and General Practice, Te Whare Wānanga o Otāgo ki Te Whanga-Nui-a-Tara, 6242, New Zealand/Aotearoa.

^* Correspondence to: samantha.murton@otago.ac.nz

Handling Editor: Tim Stokes

Journal of Primary Health Care 16(4) 357-363 https://doi.org/10.1071/HC23169

Submitted: 14 December 2023 Accepted: 20 May 2024 Published: 7 June 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of The Royal New Zealand College of General Practitioners. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Introduction

This study explored the experiences of students and their supervisors undertaking a medication review activity during a 6-week general practice module in their final year of medical school at University of Otago, Wellington, Aotearoa New Zealand.

Aim

The study sought the self-reported value of the activity in learning about prescribing, reflecting on polypharmacy, deprescribing, and changes to future practice for both student and supervisor.

Methods

All students in the final year general practice module were invited to complete a survey over a 12-month period, as were their supervisors. An abductive thematic analysis of survey results was performed.

Results

Fifty-eight percent (48/87) of students and 30% (10/33) of supervisors completed surveys. Five themes were identified in the analysis of qualitative data: value of the medication review, complexities of medicines, importance of monitoring, value of resources, and supervisor reflections on value to the student. Student and supervisor responses reflected on prescribing practice beyond what medication to give when. All responses described benefit to patients and the majority expressed thoughts on how it would change their future prescribing.

Discussion

The medication review activity in the final year general practice module provides learning opportunities for both student and general practitioner supervisor. This activity emphasises the risks of polypharmacy and how to deprescribe. This study underlines the value of medication reviews as intraprofessional communication activities, allowing reflection beyond what medication to prescribe and for what condition. The results underline the importance of reflecting on practice and aids quality improvement benefit to patients.

Keywords: clinical practice, deprescribing, medication review, medications, polypharmacy, prescription medicines, professional education, reflective practice, risk management.

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