General Practice Professor acknowledges support from Canterbury General Practice teams
GP Dee Mangin says her appointments as Professor of General Practice at both Otago and McMaster Universities have been a tribute to the Canterbury General Practice teams and patients that she has worked with.
“The professorships have been a nice acknowledgement of primary care – all the doctors, practice nurses and everyone else who has been involved in various research projects,” she says. “Almost every patient who walks through our doors has some kind of unanswered research question attached to their care. And almost all of my research work has involved trying to improve the information available to Canterbury General Practice teams. To do this has taken a lot of input and support from them.”
Prior to taking up her professorships three years ago, Dee was working as a Christchurch GP; involved in research and teaching at the University of Otago; and was Pegasus’ Clinical Leader for Research, Audit and Evaluation.
Her research has included the initial evaluations of a number of the Acute Demand projects, including a randomised trial of Extended Care at Home; studies on antibiotic resistance and urinary tract infections; a study of iron deficiency and brain development in children; studies on polypharmacy reduction; and most recently a study on whether the long term use of anti-depressants is effective in preventing depression recurrence for those treated in primary care.
The anti-depressant project involved 330 patients from Christchurch, Auckland and Nelson, who had taken Fluoxetine long term to prevent depression. After following patients for 18 months, Dee and her team found that a large group of the people taking the medication could safely stop without a recurrence of depression.
The study fits with Dee’s overarching interest in overdiagnosis and polypharmacy. Her work on these topics has been included in Small Group topics in the Pegasus Health education programme.
Dee says, “The average number of medicines being taken by people aged over 65 is now seven. The more pills you take the more likely you are to have a side effect or that one pill will interact with another pill or another condition.”
“More harm is now done through adverse drug effects than breast cancer, colon cancer and lung cancer. In Europe it is the equivalent of two jumbo jet crashes everyday, killing everyone on board.”
In the last year, Dee has spent most of her time working at McMaster University – the birthplace of evidence-based medicine – on developing tools to support primary care teams and patients in rational approaches to the reduction of medicine use and polypharmacy.
“It’s been fascinating to see another system at work. It offers a different perspective on primary care, and opportunities for more research to support General Practice.”