Reducing the environmental impact of medications and improving patient outcomes using the ECO-Rx framework

OBJECTIVE: To raise awareness about the environmental impact of medications and provide practical opportunities to reduce this effect. SOURCES OF INFORMATION: resource. MAIN MESSAGE: Environmental harms and climate change are threats to human health, yet the health care system is responsible for 4.6% of greenhouse gas (GHG) pollution in Canada. Most of this pollution is generated upstream in the supply chain where products, including medications, are produced. In primary care, medications account for 61% of GHG pollution. Medications also have other impacts on the environment including contamination of air, water, and soil. The Evidence, Collaboration, Options, Review Rx (ECO-Rx) framework was designed to support appropriate use of medications through the following: Evidence-use high-quality evidence to guide diagnosis and treatment; collaboration-involve patients in all treatment decisions; options-always consider nonpharmacologic or more sustainable pharmacologic options; and review Rx-regularly review existing prescriptions and deprescribe appropriately. CONCLUSION: By applying these principles to an entire patient roster, 1 family physician can have a large environmental impact while also improving patient outcomes, minimizing costs for patients and the health care system, and reducing provider workload through fewer refill visits, less monitoring, and fewer complications.