Incorporating ecological data into a general practice prescribing guide: using the Hazard Score

<div><p>Introduction. In 2021, the French College of General Practice called on general practitioners to incorporate environmental considerations into their clinical practice. Objective. To incorporate environmental risk data for drugs listed in the 5th edition of the 'Guide to Therapeutics in General Medicine' published by the National College of General Practitioners, using the Hazard Score. Method. The environmental impact of the selected drugs was assessed using a Hazard Score ranging from 0 to 9, available through Janusinfo.se. Developed independently of pharmaceutical manufacturers this Swedish score incorporates three dimensions: environmental persistence, bioaccumulation in fatty tissues and toxicity to aquatic organisms. For drugs without an available Hazard Score, the ten most frequently prescribed drugs in France in 2023 were identified. A literature review was carried out to assign a rating ranging from A (low environmental impact) to C (high impact). Results. Six hundred and sixty-four drugs were included. A Hazard Score was assigned to 297 drugs (44.7%). The average Hazard Score was 3.15. Ninety-seven drugs (32.7%) had a Hazard Score of 0. Among the 367 drugs without a Hazard Score (55.3%), phloroglucinol was graded B. Codeine, prednisolone, alprazolam, oxazepam, amoxicillin and clavulanic acid, tramadol, and methadone were graded C. No grade was given to zopiclone and nefopam. Conclusion. This evaluation provides general practitioners with ecological risk data, facilitating environmentally conscious prescribing practices. Integrating such information into prescribing resources represents a crucial step towards sustainable medical practice.</p></div>