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

To raise awareness about the environmental impact of medications and provide practical opportunities to reduce this effect.

The Planetary Health for Primary Care resource.

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.

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.