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Dr Ashwin Kaniah

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Hunter, Manning & Central Coast

Tell us about your background.

I’m Indian by heritage but born and raised in Malaysia. I completed my undergraduate medical degree (MB BCh BAO) as well as a B Med Sci  in Ireland in 2007 and subsequently moved to Sydney in 2010 to continue physician’s training, and trained as a medical registrar for six years before deciding to become a GP. I  also have a background in geriatric medicine and sexual health (HIV medicine). I have a special interest and am very passionate about clinical case management of dementia and aged care.

Why did you decided to become a GP?

I decided to enter GP training to hopefully contribute towards improving the overall standards of aged care in the primary care setting. GPs play the most significant role in case-managing chronic and complex patients in the community – more so when it comes to the diagnosis and management of cognitive impairment and all of the pscyho-social aspects of aged care. I hope to carve a niche for myself in terms of being a GP with a special interest in geriatric medicine and dementia.

What attracted you to undertake an academic component to your training?

Being passionate about the management of geriatric medicine and dementia as a GP, I felt that having experience in the academic arena would further add to my skill set in terms of continuing aged care-related research in the community. Being a part-time academic whilst clinically working as a GP would best suit my future goals of contributing towards improving the overall standards of aged care in Australia – in terms of primary care practice and policy.

What is your research project about?

My research topic is the deprescribing of potentially inappropriate  medications (PIMs) in patients over 65 years by GPs. GPs are being strongly urged to deprescribe potentially inappropriate or unnecessary medications in a timely manner. However to date, there is very little established information on the actual rates of deprescribing. I am designing a survey consisting of  five clinical case vignettes that will elucidate GPs responses on which medications they would choose to deprescribe in the context of the respective medical scenarios. This study will provide insight into the deprescribing behaviour of GPs in the Hunter New England and Central Coast PHN. I will also be conducting a descriptive analysis comparing the intended deprescribing behaviours against the actual deprescribing behaviours of GP registrars based on the data that has already been obtained from the ReCEnT study.

What was your motivation for the project?

I have a strong passion for geriatric medicine and dementia. Polypharmacy (which by definition is having to be on five or more medications) leads to numerous drug interactions and is one of the greatest contributing factors towards the anticholinergic and sedative effects of PIMs in the elderly. This has been proven to lead to an increased risk of falls, hospitalisation, cognitive impairment and ultimately an overall reduction in quality of life and daily functions. I hope to provide further insight into the barriers of GPs understanding, as well as the practise of deprescribing. As well as contribute towards the future enhancement of primary care practise and policy towards helping to increase the standards of aged care.

What do you see as the benefits of undertaking an academic component in your GP training?

Besides the obvious benefits with regards to carving a niche for myself as a GP with a special interest in geriatric medicine, undertaking an academic post has already began to educate me on the vast importance of clinical research in helping to change and improve current best practice as well as primary care policy. Designing my research question as well as the methodical intricacy of designing a survey has already changed my thought process in my daily practice both clinically as well as logistically –  in terms of appreciating the socio-economic demographic components of the type of patients as well as the resources available in rural versus metropolitan communities.

 

For more information on academic posts head to Academic Research.