Researchers on the UKRI MRC funded eco-directed prescribing pilot project published a new article “Do you think medicines can be prescribed in a more eco-directed, greener way? A qualitative study based on public and prescriber focus groups on the impact of pharmaceuticals in Scotland’s water environment” in The BMJ Open. This qualitative study explored public and prescriber awareness of pharmaceutical pollution in the water environment and eco-directed sustainable prescribing (EDSP) as a mitigation strategy to reduce the environmental impact of prescribing in Scotland.
Summary:
- Focus groups were used to assess public and prescriber perceptions towards the importance and feasibility of eco-directed sustainable prescribing (EDSP) to support more environmentally informed healthcare.
- A strength of the study was the paired and comparative approach which considered the public (patient voice) and prescriber viewpoints towards EDSP in Scotland.
- Transdisciplinary methods and data were integrated to develop the study design, including environmental science, qualitative health services research, prescribing and public health.
- Suggestions for more sustainable healthcare included public health awareness campaigns, better provision for pharmacy take-back schemes, clear medicine/packaging labelling, regular medicines reviews and more considered patient-centred care.
- From the prescriber perspective – EDSP resonated well with current sustainability initiatives in Scotland (eg, Realistic Medicine, switching to dry-powder inhalers), but barriers to EDSP included lack of knowledge, confidence, time and resources to implement changes.
- From the public perspective – representatives were generally open to the concept of EDSP, this decision required weighing pros/cons considering personal health choices, information accessibility and transparency, and trust in and time with prescribers.
- Although there is growing awareness among the public and healthcare professionals of pharmaceutical pollution in the environment, further education is required on the drivers, potential effects and possible interventions.
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.
This study was part of a larger research project to investigate development of 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.
Full article: https://bmjopen.bmj.com/content/15/1/e088066.full