POPLPRAC 771 : Special Topic: Multimorbidity and Complexity of Medicines Use in Older People
Medical and Health Sciences
2025 Semester Two (1255) (30 POINTS)
Course Prescription
Course Overview
The course objectives are to improve overall knowledge and skills in supporting older people with multimorbidity and complexity, to optimise medication use and improve outcomes for older people.
There is a focus on balancing benefits and harms and the potential for appropriate prescribing or treatment modification as the benefit to harm ratio changes with aging. Selection of the most appropriate drug (including from within a class such as antidepressants) for older people by considering the drug’s characteristics and property profile is covered. Selection of the most appropriate drug from within a class (e.g. ACE inhibitor, calcium channel blocker) is discussed in the context of the drugs properties and individual patient characteristics, including comorbidities
The main areas covered in this module are psychotropic medications and pain medications, medicines used for cardiovascular disease prevention and treatment, medicines for Type2 diabetes, osteoporosis and musculoskeletal conditions particularly osteoarthritis and associated pain.
These are common chronic conditions in older people and frequently co-exist with other chronic diseases. Again, there is a focus on the benefit to harm balance of treatments and how this can change with aging. appropriate medicines use is addressed, for example, in the context of relaxing glycaemic targets in diabetes and the use of bisphosphonates in osteoporosis. NSAIDs and other medicines for pain provide good models where significant risk of harm needs to be considered before use.
Finally the course gives practical examples of complex cases in robust and frail older people to apply knowledge and consider ethical and logistic issues in the real world.
Course Contacts
Professor Ngaire Kerse
General Practice and Primary Healthcare
Email: n.kerse@auckland.ac.nz
Capabilities Developed in this Course
| Capability 1: | People and Place |
| Capability 3: | Knowledge and Practice |
| Capability 4: | Critical Thinking |
| Capability 5: | Solution Seeking |
| Capability 8: | Ethics and Professionalism |
Learning Outcomes
- Describe the factors contributing to the increased risk of inappropriate medication use and medication-related harm in older adults (Capability 1.2, 3.1 and 3.2)
- Explain how polypharmacy, multimorbidity, and frailty contribute to the complexity of medication management in older populations (Capability 3.1, 3.2 and 3.3)
- Assess the implications of the increasing older population and the corresponding rise in medication use, focusing on the challenges this presents for healthcare providers (Capability 1.2, 3.1 and 3.2)
- Critically evaluate the challenges of balancing the benefits and harms of medications as individuals age, considering the unique physiological changes associated with aging (Capability 3.1, 3.2, 3.3, 4.1 and 5.1)
- Evaluate the risks and benefits associated with major domains of medicine use, including psychotropic and centrally acting medicines, cardiovascular medicines, endocrine medicines, musculoskeletal medicines, and relevant new medicines in the context of older adults (Capability 3.1, 3.2, 3.3, 4.1, 5.1 and 8.2)
Assessments
| Assessment Type | Percentage | Classification |
|---|---|---|
| 1 hour assessment(MCQ) | 15% | Individual Coursework |
| Case study analysis | 30% | Individual Coursework |
| 2 hour assessment(MCQ) | 30% | Individual Coursework |
| Discussion forum | 25% | Individual Coursework |
| 4 types | 100% |
| Assessment Type | Learning Outcome Addressed | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| 1 | 2 | 3 | 4 | 5 | ||||||
| 1 hour assessment(MCQ) | ||||||||||
| Case study analysis | ||||||||||
| 2 hour assessment(MCQ) | ||||||||||
| Discussion forum | ||||||||||
MCQ and short answer questions are based on real world cases. Cases will be based on real world experience and knowledge tested will be presented as part of the course. Application of knowledge to the cases, and common issues raised as part of care of older people in all contexts will be assessed in the cases. Cases will include all necessary detail for the learner who is not a prescriber.
Workload Expectations
This course is a standard 30 point course and students are expected to spend 300 hours all inclusive.
For this course, you can expect 30 hours online content including: watching video clips, power point presentations, reading self-directed cases spread over the 6 modules (5 hours per module),200 hours of self-directed reading, completing self-completion quiz’s and reflecting on resources (33 hours per module), 30 hours formulating online forum posts and responding to colleagues (5 hours per module). This totals 25 hours per week. then the assignment and examination is 40 hours of preparation and completion (1 hour MCQ, 2 hr case assessment, 2 hour exam (5 hours) and remaining hours for the online forum and formulation of assessment excerpt and overall preparation for assessments.
The discussion forum will be viewed to understand engagement and interactions and a specific assignment about the forum requested.
Learning Resources
Course materials are made available in a learning and collaboration tool called Canvas which also includes reading lists and lecture recordings (where available).
Please remember that the recording of any class on a personal device requires the permission of the instructor.
Student Feedback
At the end of every semester students will be invited to give feedback on the course and teaching through a tool called SET or Qualtrics. The lecturers and course co-ordinators will consider all feedback and respond with summaries and actions.
Your feedback helps teachers to improve the course and its delivery for future students.
Class Representatives in each class can take feedback to the department and faculty staff-student consultative committees.
Academic Integrity
The University of Auckland will not tolerate cheating, or assisting others to cheat, and views cheating in coursework, tests and examinations as a serious academic offence. The work that a student submits for grading must be the student's own work, reflecting their learning. Where work from other sources is used, it must be properly acknowledged and referenced. A student's assessed work may be reviewed against electronic source material using computerised detection mechanisms. Upon reasonable request, students may be required to provide an electronic version of their work for computerised review.
Class Representatives
Class representatives are students tasked with representing student issues to departments, faculties, and the wider university. If you have a complaint about this course, please contact your class rep who will know how to raise it in the right channels. See your departmental noticeboard for contact details for your class reps.
Inclusive Learning
All students are asked to discuss any impairment related requirements privately, face to face and/or in written form with the course coordinator, lecturer or tutor.
Student Disability Services also provides support for students with a wide range of impairments, both visible and invisible, to succeed and excel at the University. For more information and contact details, please visit the Student Disability Services’ website http://disability.auckland.ac.nz
Special Circumstances
If your ability to complete assessed coursework is affected by illness or other personal circumstances outside of your control, contact a member of teaching staff as soon as possible before the assessment is due.
If your personal circumstances significantly affect your performance, or preparation, for an exam or eligible written test, refer to the University’s aegrotat or compassionate consideration page https://www.auckland.ac.nz/en/students/academic-information/exams-and-final-results/during-exams/aegrotat-and-compassionate-consideration.html.
This should be done as soon as possible and no later than seven days after the affected test or exam date.
Learning Continuity
In the event of an unexpected disruption we undertake to maintain the continuity and standard of teaching and learning in all your courses throughout the year. If there are unexpected disruptions the University has contingency plans to ensure that access to your course continues and your assessment is fair, and not compromised. Some adjustments may need to be made in emergencies. You will be kept fully informed by your course co-ordinator, and if disruption occurs you should refer to the University Website for information about how to proceed.
Student Charter and Responsibilities
The Student Charter assumes and acknowledges that students are active participants in the learning process and that they have responsibilities to the institution and the international community of scholars. The University expects that students will act at all times in a way that demonstrates respect for the rights of other students and staff so that the learning environment is both safe and productive. For further information visit Student Charter https://www.auckland.ac.nz/en/students/forms-policies-and-guidelines/student-policies-and-guidelines/student-charter.html.
Disclaimer
Elements of this outline may be subject to change. The latest information about the course will be available for enrolled students in Canvas.
In this course you may be asked to submit your coursework assessments digitally. The University reserves the right to conduct scheduled tests and examinations for this course online or through the use of computers or other electronic devices. Where tests or examinations are conducted online remote invigilation arrangements may be used. The final decision on the completion mode for a test or examination, and remote invigilation arrangements where applicable, will be advised to students at least 10 days prior to the scheduled date of the assessment, or in the case of an examination when the examination timetable is published.