Conte Andreas, Sedghi Anita, Majeed Azeem, Jerjes Waseem
Faculty of Life Sciences & Medicine, King's College London, London SE1 1UL, UK.
Faculty of Medicine, Imperial College London, London SW7 2AZ, UK.
Clin Pract. 2025 Jul 31;15(8):142. doi: 10.3390/clinpract15080142.
Polypharmacy, or the concurrent intake of five or more medications, is a significant issue in clinical practice, particularly in multimorbid elderly individuals. Despite its importance for patient safety, medical education often lacks systematic training in recognising and managing polypharmacy within the framework of patient-centred care. We investigated the impact of a structured learning intervention introducing polypharmacy as a chronic condition, assessing whether it enhances medical students' diagnostic competence, confidence, and interprofessional collaboration. A prospective cohort study was conducted with 50 final-year medical students who received a three-phase educational intervention. Phase 1 was interactive workshops on the principles of polypharmacy, its dangers, and diagnostic tools. Phase 2 involved simulated patient consultations and medication review exercises with pharmacists. Phase 3 involved reflection through debriefing sessions, reflective diaries, and standardised patient feedback. Student knowledge, confidence, and attitudes towards polypharmacy management were assessed using pre- and post-intervention questionnaires. Quantitative data were analysed through paired -tests, and qualitative data were analysed thematically from reflective diaries. Students demonstrated considerable improvement after the intervention in identifying symptoms of polypharmacy, suggesting deprescribing strategies, and working in multidisciplinary teams. Confidence in prioritising polypharmacy as a primary diagnostic problem increased from 32% to 86% ( < 0.01), and knowledge of diagnostic tools increased from 3.1 ± 0.6 to 4.7 ± 0.3 ( < 0.01). Standardised patients felt communication and patient-centredness had improved, with satisfaction scores increasing from 3.5 ± 0.8 to 4.8 ± 0.4 ( < 0.01). Reflective diaries indicated a shift towards more holistic thinking regarding medication burden. The small sample size limits the generalisability of the results. Teaching polypharmacy as a chronic condition in medical school enhances diagnostic competence, interprofessional teamwork, and patient safety. Education is a structured way of integrating the management of polypharmacy into routine clinical practice. This model provides valuable insights for designing medical curricula. Future research must assess the impact of such training on patient outcomes and clinical decision-making in the long term.
多重用药，即同时服用五种或更多药物，是临床实践中的一个重要问题，在患有多种疾病的老年人中尤为突出。尽管其对患者安全至关重要，但医学教育在以患者为中心的护理框架内，往往缺乏识别和管理多重用药的系统培训。我们研究了将多重用药作为一种慢性病引入的结构化学习干预措施的影响，评估其是否能提高医学生的诊断能力、信心和跨专业协作能力。对50名医学专业最后一年的学生进行了一项前瞻性队列研究，他们接受了一个分为三个阶段的教育干预。第一阶段是关于多重用药的原则、其危险性和诊断工具的互动研讨会。第二阶段包括与药剂师进行模拟患者咨询和药物审查练习。第三阶段包括通过汇报会、反思日记和标准化患者反馈进行反思。使用干预前后的问卷评估学生对多重用药管理的知识、信心和态度。定量数据通过配对检验进行分析，定性数据从反思日记中进行主题分析。干预后，学生在识别多重用药症状、提出减药策略以及在多学科团队中工作方面有了显著改善。将多重用药作为主要诊断问题进行优先排序的信心从32%提高到了86%（<0.01），诊断工具的知识从3.1±0.6提高到了4.7±0.3（<0.01）。标准化患者感觉沟通和以患者为中心的程度有所提高，满意度得分从3.5±0.8提高到了4.8±0.4（<0.01）。反思日记表明在药物负担方面朝着更全面的思维转变。样本量小限制了结果的普遍性。在医学院将多重用药作为一种慢性病进行教学可提高诊断能力、跨专业团队合作和患者安全。教育是将多重用药管理纳入常规临床实践的一种结构化方式。该模式为设计医学课程提供了有价值的见解。未来的研究必须长期评估此类培训对患者结局和临床决策的影响。
