The British Journal of General Practice published an article calling for reductions in overprescribing in the NHS – as a major healthcare and environmental priority. The article draws on the NHS Sustainability Strategy’s target for reductions in the environmental impact of medicines, and further supports that clinicians must be given greater access to the environmental impacts of drugs they prescribe.
Article available here: https://bjgplife.com/tackling-overprescribing-a-must-for-climate-action/
Healthcare contributes 4-5% of global green house gas emissions. In the UK medicines are estimated to contribute to 25% of NHS emissions, with 5% related to meter-dose inhalers and anaesthetic gases and the majority (20%) due to the pharmaceutical supply chain (i.e., manufacturing, transportation, dispensing, use).
Addressing overprescribing can have a significant impact on reducing emissions related to medicines. It is estimated that nationally 10% of medicines in primary healthcare are overprescribed (i.e., not needed or wanted), which can lead to poor adherence in usage – wasting both NHS resources and costs, while also contributing to carbon footprints.
Increasing public and prescriber awareness of environmentally-friendly healthcare, in recognition that not every medicine prescribed will improve health outcomes, could have a significant impact on the environmental impact of the NHS.
This could include non-pharmacological interventions such as:
- Encouraging low-salt diets and exercise to reduce prescription of antihypertensives,
- Psychotherapy and changing sleep habits to reduce or avoid prescription of antidepressants,
- Pain management and rehabilitation through physiotherapy.
Patient and prescriber shared decision making is vital to the success and ongoing health benefits of these pharmacological and non-pharmacological interventions, and should always be a key point in any visit to the GP or prescriber. To support this, the National Institute for Health and Care Excellence (NICE) is now developing patient aids detailing carbon footprints and environmental impact of medications, alongside suitability.
The time and resource requirements are continuing challenges to address overprescribing in primary healthcare, but it is justified to recognise and begin step-changes in practice to reduce the environmental impact of medicines.