Sustainable pharmacy and prescribing
Key actions in sustainable pharmacy and prescribing can minimize the environmental harms of medications throughout their lifecycle and address increased medication-related risks due to climate change.
CASCADES pan-Canadian networks
We are working with quality improvement teams and professional associations to share knowledge and resources for sustainable inhaler practices.
Join our Community of Practice
The Sustainable Inhalers Community of Practice meets on a monthly basis and is open to all healthcare workers looking to make an impact in this clinical area. Participants are encouraged to attend on a regular basis, but are welcome to drop in based on their schedules. During these meetings, participants:
- Share published updates
- Share updates on their own inhalers projects
- Share ideas and troubleshoot challenges
- Build their network of sustainability champions.
The Inhalers CoP is Chaired by Dr. Valeria Stoynova.
To join the discussion, contact Ivy Lam.
This work is being led by a clinical champion:
Chair: Valeria Stoynova, Clinical associate professor, Department of Medicine, University of British Columbia, and general internist, Vancouver Island Health Authority, Victoria, British Columbia.
Dr. Stoynova is available to discuss project ideas. Please contact Ivy for availability.
Upcoming training and events
Implementation resources for sustainable pharmacy and prescribing practices
Medication Optimization for Sustainability in Inpatient Care
A step-by-step guide to addressing the environmental impacts of polypharmacy through medication optimization in inpatient care.
Climate Resilient, Low Carbon Sustainable Pharmacy Playbook
A step-by-step guide for pharmacy professionals.
Climate Conscious Inhaler Practices in Inpatient Care
A step-by-step guide to more sustainable inhalers in inpatient care
Clinical Order Set Redesign
Prioritizing Inhaler Wardstock
Tamper Sealing the Inhaler Cap
Low-Volume versus High-Volume HFA Inhaler Procurement
Hospital Formulary
Multidose Medication Discharge Policy
Inpatient provider-specific information
- Inpatient Pharmacists poster
- Inpatient Pharmacy Technicians poster
- Nurses poster
- Respiratory Therapists poster
- Physician and Trainee infographic
- Trainee video
Outpatient provider-specific information
Patient information
Climate Conscious Inhaler Prescribing in Outpatient Care
A step-by-step guide to more sustainable inhalers in primary care
An interactive web tool including province-specific information on coverage, cost, and indication.
More resources on sustainable pharmacy and prescribing
Playlist
Sustainable pharmacy and prescribing projects in development
Sustainable Hospital Pharmacy Practices
Hospital pharmacy straddles both a clinical and an operational role. Hospital pharmacy practices generate substantial volumes of waste, including packaging materials and expired medications, contributing to environmental pollution. The hospital pharmacy lacks standardized approaches for addressing environmental sustainability, leading to inefficiencies and missed opportunities to reduce their impact on climate change. Canadian Society of Hospital Pharmacists in collaboration with CASCADES will develop a playbook to cover sustainable pharmacy practices in pharmaceutical procurement, storage, dispensing, waste management, and overall pharmacy operations for Canadian institutions.
PI: Rita Dhami, Chief Pharmacy Officer, Canadian Society of Hospital Pharmacists
Medication Optimization and Greenhouse Gas Savings
In complex care or post-acute care, patients have multiple co-morbidities and polypharmacy upon admission. This project will look at medication optimization principles which improve patients’ outcomes and—as appropriate—decrease the number of medications per patient, reduce financial cost to the system, reduce medical waste, and decrease greenhouse gas emissions.
PI: Myles Sergeant, Hospitalist, Hamilton Health Sciences; Partnerships Lead, PEACH Health Ontario; Executive Director, Canadian Coalition for Green Health Care
Sustainable asthma care in the pediatric emergency department
This project will adapt sustainable inhaler prescribing principles and practices for the pediatric emergency department. The project is based on the four principles of sustainable practice, focusing on educating and encouraging use of the lowest impact MDIs for younger patients and increasing pediatric providers’ comfort in considering dry powder inhalers when appropriate. The project aims to develop a tool for rapid assessment of readiness to use a DPI that can be easily applied in the ED setting.
PI: Katie Gardner, Physician (Pediatric Emergency Medicine), IWK Health
We want to hear from you
Materials created by CASCADES are shared under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International Public License (CC BY-NC-SA 4.0).
While it is not a requirement under the license, we would be grateful if you would let us know where and how you use, share or adapt our materials.
Other action areas
Care pathways
Key actions can minimize the environmental harms of medications throughout their lifecycle and address increased medication-related risks due to climate change.
Many opportunities exist to address the resource intensity of perioperative care while ensuring and promoting high quality care.
Comprehensive person-centered primary and community care can support health and wellbeing and reduce the need for more resource intensive services.
Practitioners across specialties can take meaningful steps to reduce the environmental impacts of their practice and safeguard patient and population health.
Health services can promote health, including by delivering healthy food, effective chronic disease management, and climate-adapted clinical care.
System enablers
Sustainability is intrinsically linked with both quality care and patient safety and can be embedded within these efforts.
Leadership and good governance are needed to develop and deliver effective climate and sustainability strategy.
The shift to climate resilient and sustainable health systems requires accurate assessment of healthcare’s environmental impacts.
Health systems can leverage their purchasing power to influence vendors and shape markets for sustainable and resilient health sector products and services.
Healthy food, digital innovation and effective waste management are among the key enablers of low-carbon, sustainable and climate-resilient health systems.