The urgency to address climate change is undeniable, and every sector, including the healthcare sector, must play its part.

Our work is responsible for five per cent of greenhouse gas emissions, with pharmaceuticals alone contributing another five percent to that total. Our sector’s environmental impact from medications can stem from the chemical composition of Active Pharmaceutical Ingredients (APIs), which directly affect environmental health, the manufacturing and distribution methods contributing to a sizable carbon footprint, or the pharmaceutical waste challenges. 

These statistics serve not only as a wake-up call to us all, but they can also be motivators. Pharmacy professionals possess a unique opportunity to drive change. Consider the life cycle of a medicine – from its inception to disposal. At each stage, from design to prescription, we have the power to implement sustainable practices and reduce our environmental impact. 

Our work is responsible for five per cent of greenhouse gas emissions, with pharmaceuticals alone contributing another five percent to that total.

It’s with this in mind that CSHP has committed itself to supporting and advocating on behalf of the profession to make pharmacy’s voice heard and stimulate action in areas that require multi-agency or systemic change, which includes climate change in health care. One of our partners in this includes Choosing Wisely Canada, who have embarked on the development of climate-conscious recommendations through leadership and collaboration with national society and association partners, inviting CSHP along to help given the two organization’s alignment, specifically relating to environmental sustainability in healthcare and especially in the context of medication management.

CSHP, in collaboration with the Canadian Pharmacist Association (CPhA), represent pharmacy professionals in a range of practice settings. Both organizations shared Climate Action recommendations relevant to their memberships. Consequently, CSHP worked alongside CPhA to develop five joint recommendations, alongside crafting an additional five climate-focused recommendations tailored to hospital pharmacy based on current research.

Here are the 10 Climate Action recommendations: 

• CSHP and CPhA joint climate action recommendations: 

– Don’t prescribe greenhouse gas-intensive metered-dose inhalers (MDIs) for asthma and/or COPD where an alternative inhaler with a lower carbon footprint (e.g. dry powder inhaler (DPI), soft-mist inhaler, or MDI with a low greenhouse gas potential propellant) containing medications with comparable efficacy is available, and where the patient has demonstrated adequate technique and patient preference has been considered.

– Don’t start or continue medications without an indication or where the risks outweigh the benefits.

– Don’t pour any pharmaceuticals or chemicals down sinks, toilets, drains or dispose of in the trash.

– Don’t print prescription or educational materials when providers and patients have access to digital communication.

– Don’t use disposable gloves when standard hand hygiene disinfection practices are safe and sufficient.

• CSHP climate action recommendations:

– Don’t continue an intravenous medication when and if clinically appropriate to step down to oral therapy.

– Don’t use desflurane when other anesthetic drugs and techniques are equally effective and less harmful to the environment.

– Don’t discard medications that are appropriate for re-dispense.

– Don’t continue medications upon hospital transitions (admission, transfers, and discharge) unless there is a clinical indication.

– Don’t make formulary decisions without consideration of environmental impact.

As of May 15, 2024, Choosing Wisely Canada unveiled over 40 groundbreaking recommendations spanning over 20 clinical specialties, shedding light on tests, treatments, and procedures detrimental to the environment. These directives serve as a rallying call, urging clinicians to cease or curtail low-value practices and champion the health of both patients and the planet. CSHP had the privilege of contributing to the program launch through a webinar spotlighting Climate Action recommendations alongside its peers at the Canadian Critical Care Society. With hopeful hearts, CSHP believes that our recommendations, alongside those of fellow societies, will herald positive transformations in patient health and foster a brighter, healthier future for our planet. Together, let’s forge ahead on this journey of healing and sustainability!

By Kiet-Nghi Cao

Kiet-Nghi Cao is CSHP’s Professional Practice Specialist and staff liaison to the Sustainability in pharmacy Task Force.