Abstract of the research

Deprescribing of medicines, especially in older patients, is as important a task for clinicians as prescribing.

GP registrars (trainees) are an important group to consider in measures to promote rational use of medicines, including deprescribing, as they are establishing patterns of practice that may be long-lasting.

The researchers conducted an educational program in a large GP Training organisation, promoting rational deprescribing of inappropriate medicines in older patients. Compared to other (control) training organisations, they found an increase in deprescribing of medicines identified as problematic in older patients but this increase was not statistically significant.

What is the purpose of the research?

This study aimed to develop and test the effectiveness of an educational program designed to increase Australian GP registrars’ (trainees’) deprescribing of inappropriate medicines in older patients (patients aged 65 or older).

The researchers did this by employing a multicomponent approach with a focus on registrars reviewing patients’ medicines regimens and on collaboration of registrars with their supervisors, and involving their patients and/or their carers) in deprescribing decisions.

What did the researchers do?

The researchers developed an educational program based on behaviour change theory that included an online module, an education session (tailored for registrars and another for supervisors), and one-on-one registrar-supervisor educational exercises.

The study employed a study design with a control group but there was no random allocation of registrars or regions to this educational program or to usual educational practice. The study was nested within an ongoing cohort study of Australian GP registrars’ in-consultation clinical and educational practice, the Registrar Clinical Encounters in Training (ReCEnT) study.

What did the researchers find?

Analyses included 779 educational program-receiving registrars and 438 control registrars . Educational program group registrars showed a moderate increase in deprescribing of medicines identified as problematic in older patients (29%) but this increase was not statistically significant.

How can the research be used?

The evaluation of a multicomponent behaviour change theory-based approach adopted in this study demonstrates the complexity of delivering and evaluating educational innovations.

Continued education for registrars around rational deprescribing of inappropriate medicines in older patients is essential. This study is an initial step in evaluating the behaviour change approach to this task and further investigation and extended observation is warranted.

Read the full research report published in the Health Education in Practice Journal - Vol. 7 | No. 1 | 2024