Education on environmentally sustainable prescribing is vital

Environmentally sustainable prescribing should be embedded in undergraduate and postgraduate health care education. This was one of the conclusions from a session co-hosted by RPS Scotland and the Scottish Academy of Medical Royal Colleges at yesterday’s NHS Education for Scotland annual virtual conference.

Delegates at the session were asked about their current knowledge on the environmental impact of medicines, and most said they or their teams needed more education. They also needed more information and resources when prescribing to be able to consider environmental issues.

Sharon Pfleger, Consultant in Pharmaceutical Public Health at NHS Highland, told the session:

“There’s a lot of work to be done to reduce carbon emissions. The NHS has identified the use of metered-dose inhalers as its second biggest cause of carbon emissions as the propellant gases have significant global warming potential. It’s important that prescribers check that these types of inhaler are appropriate for everyone who uses them, and that patients know how to use these inhalers correctly, so the medicine is not wasted. Switching to lower carbon inhalers may be a suitable option for some patients after a consultation with their prescriber.

However, we also know that there's more to climate change than carbon emissions. Pollution from medicines is contributing to the ecological crisis, harm to aquatic life and biodiversity loss. Furthermore, pharmaceutical pollution causes physiological, behavioural and reproductive changes in aquatic life, as well as accelerating antimicrobial resistance.

“Every time a patient takes a medicine, between 30-100% will end up going down the toilet and into our wastewater systems, which cannot effectively remove them. Ultimately prescribing pollutes our rivers and oceans, so it’s important that all prescribing is necessary and proportionate.”

In polls during the session, 97% of delegates said that sustainable prescribing should be embedded into education, and 100% said health care leaders should do more to support environmentally sustainable prescribing and medicines use.

RPS and the Scottish Academy are currently finalising a joint statement on reducing the environmental impact of prescribing which follows a round table the two organisations co-hosted to bring together all health professions in Scotland who prescribe.

Clare Morrison, Director for Scotland at RPS, said:

“It is vital that we take action on environmental sustainability, and we heard a clear message today that health professions need more education to be able to take action. I am delighted that RPS is working jointly with the Scottish Academy of Medical Royal Colleges to try to achieve change.”