Over the past 12 month, NHS Highland, the University of the Highlands and Islands – Environmental Research Institute (UHI-ERI), and the University of Nottingham have collaborated on the UKRI MRC project “Developing frameworks for eco-directed sustainable prescribing: Towards reducing environmental pollution from healthcare practices”. This week, the research team, project partners, and wider stakeholder group came together at the Royal Pharmaceutical Society (and online) for a cross-disciplinary dissemination and workshop event, to review project outputs and discuss next stage activity.
Project outputs and further information on next steps will be posted online once available.
Find out more on the Project webpage
The prescription of a medicine (pharmaceutical) is the most common healthcare intervention to diagnose, prevent, treat or cure disease. However, this activity negatively impact the environment and contributes to NHS Scotland’s environmental footprint. Healthcare sustainability targets in Scotland call for improvements to prescribing and medicine use, to reduce its environmental impact. To achieve this, healthcare practitioners and prescribers require robust and comprehensive information on the environmental impact of pharmaceuticals to support more sustainable prescribing. This project developed a framework with environmental impact data of pharmaceuticals in the Scottish water environment, for consideration in prescribing decision-making. Researchers utilised a transdisciplinary approach combining environmental science, prescribing, and qualitative health services methods and data. Objectives included: 1) selection of pharmaceuticals and framework criteria through Nominal Group Technique (NGT) consensus methods considering environmental and clinical perspectives; 2) application of novel modelling to create the framework with environmental impact data; 3) evaluation of prescriber and public perceptions of eco-directed prescribing and information provision through focus groups. Through NGT consensus activities, participants across the environment, medicines regulation, prescribing, public health and pharmaceutical industry sectors reached consensus on pharmaceuticals and criteria for the framework. Four pharmaceuticals were selected: carbamazepine, clarithromycin, fluoxetine, and propranolol, considering clinical and environmental perspectives. Prescribing data (population standardised, by mass) and environmental data were integrated into Scotland-wide risk models, with mapping to visualise risk levels in freshwater catchments. Prescriber focus groups found that more education, and clear, robust tools, were needed to support evidence-based decisions on eco-directed prescribing. This project has helped to increase awareness amongst stakeholders, healthcare professionals and the public on environmental impact of pharmaceuticals, and has progressed cross-sector activity to introduce environmental data into healthcare decision-making.
The research team worked in partnership with the James Hutton Institute, Scottish Water, the Scottish Environment Protection Agency, and the University of Uppsala.
Thank you to the project partners and wider stakeholder group for your valuable input and support on this project!