A pathway to net zero emissions for healthcare

Salas, Renee N; Maibach, Edward; Pencheon, David; Watts, Nick; Frumkin, Howard

doi:10.1136/bmj.m3785

Cited by 92 publications

(79 citation statements)

References 71 publications

(26 reference statements)

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“…In the U.S., groups such as the Medical Society Consortium on Climate and Health share case studies and other resources to amplify grassroots action 34 . Globally, health professionals are being called on to advocate for planetary health and lead further decarbonization efforts, including in pharmacies 35 …”

Section: Progress Towards a Sustainable Health Care Systemmentioning

confidence: 99%

“…In health care organizations, pharmacists involved in implementing procurement policies can advocate for consideration of environmental impacts. Responsible purchasing policies like this can reduce emissions embedded in the pharmaceutical supply chain and have been highlighted as a key step towards decarbonization of health care 35 …”

Section: Pharmacists As Sustainability Leadersmentioning

confidence: 99%

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Climate care is health care: A call for collaborative pharmacy action

Gahbauer

Gruenberg

Forrester

et al. 2021

J Am Coll Clin Pharm

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Climate change and ecosystem degradation threaten human health and exacerbate pre‐existing social determinants of health. The prescription drug sector accounts for a significant portion of health care system contributions to greenhouse gas and waste production. Pharmacists are therefore well‐positioned to transform health care toward environmentally sustainable models; however, additional pharmacist education on climate mitigation and sustainable practice is needed. A team of practicing pharmacists and pharmacy students from the United States and Australia aimed to define pharmacists' roles in environmental stewardship by evaluating pre‐existing pharmacy‐led efforts in reducing waste, greenhouse gas emissions, and other health care‐associated environmental impacts. We also describe opportunities for education in pharmacist training as a means to enhance the profession's capacity for environmentally sustainable health care practice and leadership. Information on specific drugs' ecological footprints is increasingly available; pharmacists, as drug information experts, can incorporate sustainability considerations into their drug procurement and prescribing recommendations. Pharmacists also play a critical role in public education about environmentally responsible drug disposal. Finally, we suggest collaborative steps that U.S. organizations involved in pharmacy education could take to ensure that future “practice readiness” includes competence in sustainable health care practices.

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Section: Progress Towards a Sustainable Health Care Systemmentioning

confidence: 99%

Section: Pharmacists As Sustainability Leadersmentioning

confidence: 99%

Climate care is health care: A call for collaborative pharmacy action

Gahbauer

Gruenberg

Forrester

et al. 2021

J Am Coll Clin Pharm

View full text Add to dashboard Cite

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“…In addition to these considerations, the ongoing climate emergency and novel coronavirus (COVID-19) pandemic are both contributing to a growing and urgent need to re-consider how healthcare service is delivered [16,17]. Other models of follow-up, including those using telehealth, present an opportunity to potentially decrease low value or unnecessary care [18], reduce environmental impacts of healthcare [17], and reduce nosocomial infection risk [19]. Telehealth may be especially valuable in the Australian context where a up to 30% of the population live remote to the major cities [20].…”

Section: Background and Rationale {6a}mentioning

confidence: 99%

Can Patient-Led Surveillance Detect Subsequent New Primary or Recurrent Melanomas and Reduce the Need for Routinely Scheduled Follow Up? A Protocol for the MEL-SELF Randomised Controlled Trial.

Ackermann

Smit

Janda

et al. 2021

Preprint

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Background: Most subsequent new primary or recurrent melanomas might be self-detected if patients are trained to systematically self-examine their skin and have access to timely medical review (patient-led surveillance). Routinely scheduled clinic visits (clinician-led surveillance) is resource-intensive and has not been shown to improve health outcomes; fewer visits may be possible if patient-led surveillance is shown to be safe and effective. The MEL-SELF trial is a randomised controlled trial comparing patient-led surveillance with clinician-led surveillance in people who have been previously treated for localised melanoma. Methods: Stage 0/I/II melanoma patients (n=600) from dermatology, surgical, or general practice clinics in NSW Australia, will be randomised (1:1) to the intervention (patient-led surveillance, n=300) or control (usual care, n=300). Patients in the intervention will undergo a second randomisation 1:1 to polarised (n=150) or non-polarised (n=150) dermatoscope. Patient-led surveillance comprises an educational booklet, skin self-examination (SSE) instructional videos; 3-monthly email/SMS reminders to perform SSE; patient-performed dermoscopy with teledermatologist feedback; clinical review of positive teledermoscopy through fast-tracked unscheduled clinic visits; and routinely scheduled clinic visits following each clinician’s usual practice. Clinician-led surveillance comprises an educational booklet and routinely scheduled clinic visits following each clinician’s usual practice. The primary outcome, measured at 12-months, is the proportion of participants diagnosed with a subsequent new primary or recurrent melanoma diagnosed at an unscheduled clinic visit. Secondary outcomes include time from randomisation to diagnosis (of a subsequent new primary or recurrent melanoma and of a new keratinocyte cancer), clinicopathological characteristics of subsequent new primary or recurrent melanomas (including AJCC stage), psychological outcomes, and healthcare use. A nested qualitative study will include interviews with patients and clinicians, and a costing study we will compare costs from a societal perspective. We will compare the technical performance of two different models of dermatoscope (polarised vs non-polarised).Discussion: The findings from this study may inform guidance on evidence-based follow up care, that maximises early detection of subsequent new primary or recurrent melanoma and patient wellbeing, while minimising costs to patients, health systems, and society.Trial registration: Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12621000176864. Registered 18 February 2021, https://www.anzctr.org.au/ACTRN12621000176864.aspx

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“…The good news, as Renee Salas and colleagues explain,7 is that this presents us with a big opportunity. Net zero is technically feasible across much of the world’s economy, they say.…”

mentioning

confidence: 99%