Researchers on the UKRI MRC funded eco-directed prescribing pilot project published a new article “Co-developing frameworks towards environmentally directed pharmaceutical prescribing in Scotland – A mixed methods study” in Science of the Total Environment. The research team included transdisciplinary researchers and experts in environmental science and modelling, public health, and qualitative health services research from NHS Highland, the University of Nottingham, the James Hutton Institute, and the Environmental Research Institute-UHI. Project partners included OHBP members from Scottish Water, the Scottish Environment Protection Agency, and the University of Uppsala. The study demonstrates a novel, interdisciplinary approach to develop tools aiding collation and integration of environmental information into healthcare decision-making, and advocates for greater knowledge sharing and collaboration across sectors in establishing more eco-directed healthcare practices in future.
Highlights:
- This study explored eco-directed prescribing in Scotland to reduce the impact of pharmaceuticals in the water environment and inform more sustainable healthcare practices.
- The research team employed a mixed-methods approach, integrating public health, environmental science, computational modelling, and health services research to co-develop the framework.
- Consensus developmental techniques were used to achieve stakeholder agreement on pharmaceuticals and framework criteria, and Bayesian Belief Network modelling predicted the environmental impact of selected pharmaceuticals.
- The pollution risk score was predicted for four key pharmaceuticals, with clarithromycin posing the highest risk in the majority of modelled catchments. Maps visualised the probability of 40 freshwater catchments exceeding the predicted risk scores.
- This proof-of-concept study demonstrated a novel method to incorporate environmental data into healthcare decision-making, and future work will seek to refine the model and enhance the communication of environmental risks to healthcare professionals.
The OHBP participated in the stakeholder workshops, supported the model development, and oversaw progress of this study. The national prescribing data, wastewater treatment data, and measured environmental concentrations of pharmaceuticals were accessed through the OHBP’s Pharmaceuticals in the Environment data visualisation tool, hosted by SEPA. The tool includes Public Health Scotland’s community prescribing data, and regulatory monitoring data from the Chemicals Investigation Programme (CIP Scotland). The study was funded by the UKRI Medical Research Council and Scottish Water.
Find the full article at: https://www.sciencedirect.com/science/article/pii/S0048969724070864