Developing frameworks for eco-directed sustainable prescribing

  • Research type

    Research Study

  • Full title

    Developing frameworks for eco-directed sustainable prescribing: Towards reducing environmental pollution from healthcare practices

  • IRAS ID

    322050

  • Contact name

    Sharon Pfleger

  • Contact email

    sharon.pfleger@nhs.scot

  • Sponsor organisation

    NHS Highland

  • Clinicaltrials.gov Identifier

    2198SG, Co-sponsor University of the Highlands and Islands reference number

  • Duration of Study in the UK

    1 years, 0 months, 0 days

  • Research summary

    The prescription of a medicine is the most common intervention in healthcare – but this activity negatively impacts the environment, and pharmaceutical pollution is now a well-recognised global public health and environmental issue. Healthcare sustainability targets call for improvements to prescribing and medicine selection, as current practices are unsustainable. Improving medicine selection and use can reduce pharmaceutical pollution from healthcare. This UKRI MRC funded project will develop and evaluate an eco-directed prescription framework that incorporates environmental sustainability with clinical and cost effectiveness. This proposes that if pharmaceuticals are of comparable medical efficacy, safety, and effectiveness, then the environmental impact (e.g., drug ecotoxicity, predominance towards AMR) should be considered during the formulary process to better inform prescribers, enabling them to make more sustainable prescribing choices. The research investigators (representing NHS Highland, University of the Highlands and Islands, and University of Nottingham) will interrogate environmental and prescribing data available through open-access databases and NHS repositories, evaluate ecotoxicological data and drug physicochemical properties to develop environmental hazard indicators, prioritise criteria through structured consensus and focus group activity, develop a robust decision-making formulary framework, and engage with patients, practitioners, and prescribers to assess suitability. The investigators will work with project partners and networks/stakeholder groups to establish effective cross-organisational collaboration, disseminate outputs, and develop post project activity for a pilot trial towards implementation. This project will be an innovation-first for the UK, providing new knowledge on methods and data required for eco-directed prescribing and leading to new understanding and awareness of the environmental impact of pharmaceutical prescribing. It will create opportunities for improvements to the quality of medicine prescribing and use in the UK, and will benefit the NHS, practitioners/prescribers, patients and the public through enabling better informed and more sustainable prescribing and medicine choices.

  • REC name

    East of England - Cambridge Central Research Ethics Committee

  • REC reference

    22/EE/0307

  • Date of REC Opinion

    27 Jan 2023

  • REC opinion

    Further Information Favourable Opinion