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Zou B, Sung S, Drummond I, Tang L, Tejani AM. Understanding medication recycling practices in Canadian hospitals. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2024:riae026. [PMID: 38865359 DOI: 10.1093/ijpp/riae026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 05/31/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND Medication recycling within hospitals has proven financial and possible environmental benefits according to local evaluations done in British Columbia. Despite this, the extent of medication recycling in Canadian hospitals remains unclear in the literature. OBJECTIVE(S) To determine if Canadian hospitals recycle medications, provide an estimate of how much medication is recycled by dosage form, and identify medication recycling barriers through the distribution of a cross-sectional survey. METHODS A nine-question survey was distributed to 171 hospital pharmacy departments across Canada that consented to complete the survey. The survey identified whether sites recycled unused medications, an estimate of how much is recycled based on dosage form, and barriers to recycling. KEY FINDINGS Of 62 respondents, the majority indicated they do have medication recycling procedures; however, the frequency of recycling is suboptimal (30-50% of medications are not recycled), and not all medication types are always recycled. Individually packaged oral tablets were most often recycled, and oral liquid medications were least often recycled. Many multi-dose medications were not tamper-proofed. Most respondents selected "sanitization/infection control" and "resource constraint" as reasons for not recycling all medications. CONCLUSIONS Among respondents, the proportion and type of unused medicines that are recycled varied. For sites that did not respond, this might suggest that medication recycling is not a priority. This could represent a missed opportunity to standardize practices and increase medication recycling in hospitals, both of which could represent a meaningful step towards responsible use of medications and reduction of negative impacts on human health and the environment.
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Affiliation(s)
- Brenda Zou
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Sophia Sung
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Isla Drummond
- Department of Pharmacy, Lions Gate Hospital, North Vancouver, BC V7L 2L7, Canada
| | - Linda Tang
- Department of Pharmacy, St. Paul's Hospital, Vancouver, BC V6Z 1Y6, Canada
| | - Aaron M Tejani
- Lower Mainland Pharmacy Services, Langley, BC V2Y 0A1, Canada
- Department of Anaesthesiology, Pharmacology & Therapeutics, University of British Columbia, Therapeutics Initiative, Vancouver, BC V6T 1Z3, Canada
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Bærøe K, Bhopal AS, Gundersen TO. Towards an environmentally sensitive healthcare ethics: ten tasks and one model. JOURNAL OF MEDICAL ETHICS 2024; 50:382-383. [PMID: 38443166 DOI: 10.1136/jme-2024-109875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 02/27/2024] [Indexed: 03/07/2024]
Affiliation(s)
- Kristine Bærøe
- Institute of Health and Society, University of Oslo Centre for Medical Ethics, Oslo, Norway
- University of Bergen Faculty of Medicine and Dentistry, Bergen, Norway
| | - Anand Singh Bhopal
- Department of Global Health and Primary Care, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - TOrbjørn Gundersen
- University College of Norwegian Correctional Service, Lillestrøm, Norway
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Golemiec B, Robertson M, Poon V, Foley M, Parker CM, McGann C, O'Callaghan N, Digby GC. Improving Access to Care, Patient Costs, and Environmental Impact Through a Community Outreach Lung Cancer Rapid Assessment Clinic. JCO Oncol Pract 2024:OP2300657. [PMID: 38696740 DOI: 10.1200/op.23.00657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 02/26/2024] [Accepted: 03/26/2024] [Indexed: 05/04/2024] Open
Abstract
PURPOSE In Southeastern Ontario, increased patient distance from the regional lung cancer diagnostic assessment program (LDAP) is associated with a lower likelihood of patient care via LDAP while receiving care via LDAP is associated with improved survival. We implemented an LDAP outreach clinic to provide specialist assessment for patients with suspected lung cancer at a regional community hospital and assessed the impact on timeliness and accessibility of care. MATERIALS AND METHODS The Kingston Health Sciences Centre LDAP team engaged with community hospital partners to develop and launch the LDAP outreach clinic. We performed a retrospective chart review of LDAP patients (N = 1,070) before (August-November 2021; n = 234) and after implementation of the outreach clinic (November 2021-October 2022; n = 836). Descriptive data are reported as No. (%). Unpaired t tests and statistical process control charts assess for significance. A cost analysis of out-of-pocket patient costs related to travel and parking is presented in 2022 Canadian dollars (CAD). RESULTS Compared with a 3-month matched time period before (August-October 2021) and after outreach clinic (August-October 2022), the mean time from referral to assessment and time from referral to diagnosis decreased from 20.3 to 14.4 days (P = .0019) and 40.0 to 28.9 days (P = .0007), respectively. Over 12 months, the total patient travel was reduced by 8,856 km, which combined with parking cost-savings, resulted in patient out-of-pocket savings of CAD $5,755.60 (CAD $47.60/patient). Accounting for physician travel, the total travel saved was 5,688 km, corresponding to reduced CO2 emissions by 1.9 tCO2. CONCLUSION Implementation of a lung cancer outreach clinic led to improved timeliness of care, patient cost-savings, and reduced carbon footprint while serving patients in their community.
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Affiliation(s)
- Breanne Golemiec
- Department of Medicine, Queen's University, Kingston, ON, Canada
- Division of Respirology, Queen's University, Kingston, ON, Canada
| | - Madison Robertson
- Kingston Health Sciences Center, Queen's University, Kingston, ON, Canada
| | - Vincent Poon
- Department of Medicine, Division of Medical Oncology, University of British Columbia, Vancouver, BC, Canada
| | - Mary Foley
- Kingston Health Sciences Center, Queen's University, Kingston, ON, Canada
| | - Christopher M Parker
- Department of Medicine, Queen's University, Kingston, ON, Canada
- Division of Respirology, Queen's University, Kingston, ON, Canada
| | - Craig McGann
- Division of Respirology, Queen's University, Kingston, ON, Canada
| | - Nicole O'Callaghan
- Cancer Center of Southeastern Ontario, Queen's University, Kingston, ON, Canada
| | - Geneviève C Digby
- Department of Medicine, Queen's University, Kingston, ON, Canada
- Division of Respirology, Queen's University, Kingston, ON, Canada
- Department of Oncology, Queen's University, Kingston, ON, Canada
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Shojania KG. Is targeting healthcare's carbon footprint really the best we can do to help address the climate crisis? BMJ Qual Saf 2024; 33:205-208. [PMID: 37666662 DOI: 10.1136/bmjqs-2023-016312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 08/23/2023] [Indexed: 09/06/2023]
Affiliation(s)
- Kaveh G Shojania
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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Bonaldi A, Vernero S. Choosing Wisely Italy, and the role of doctors in containing the climate emergency. Dermatol Reports 2023; 15:9881. [PMID: 38196896 PMCID: PMC10774844 DOI: 10.4081/dr.2023.9881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 10/26/2023] [Indexed: 01/11/2024] Open
Abstract
The philosopher of science, Telmo Pievani, in his beautiful and passionate presentation on 30 September 2023, at the conclusion of the 60th National Congress of the Italian Association of Hospital Dermatologists (ADOI) held in Vicenza, reminded us with simple words and concrete examples of the devastating impact of human behavior on the environment and biodiversity, highlighting the growing deterioration of the delicate natural balances that preserve terrestrial ecosystems and with them life on our planet [...]
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Braithwaite J, Pichumani A, Crowley P. Tackling climate change: the pivotal role of clinicians. BMJ 2023; 382:e076963. [PMID: 37770093 DOI: 10.1136/bmj-2023-076963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/03/2023]
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