Sustainable Drug Use: Role of Pharmacoepidemiologists and Their Tools Addressing Environmental Impact of Drug Utilization

Background: The WHO called climate change "the single biggest health threat facing humanity". In industrialized countries, healthcare systems account for closer to 10% of national emissions, with prescription drug use being the third biggest contributor. Drug utilization is far from sustainable. Issues range from overuse and inappropriate use among prescribers and patients to stockpiling and inappropriate waste management. An increasing number of studies have shown traces of medicines in water from sewage treatment plants as well as in lakes and rivers across all continents. Pharmacoepidemiologists are equipped to address many of these issues. We have recently formed Environmental Pharmacoepidemiology (EnvPE) SIG, research addresses intersection among medications, medical devices, vaccines and environmental factors and influences.

Objectives: This symposium will focus on drug utilization and pharmaceutical waste, an important EnvPE area, addressing the following critical questions: How can pharmacoepidemiologists reduce the environmental and health burdens from pharmaceuticals?: What pharmacoepidemiology method tools can be used? The symposium is of interest for all researchers, healthcare professionals and policymakers promoting sustainable use of medicines.

Description: The symposium will consist of four presentations, targeted to different approaches in how to assess environmental aspects on drug utilization. This will be followed by a panel-discussion on how pharmacoepidemiologists can promote a more “environmental-friendly” drug prescribing and use.

1. Introduction to environmental pharmacoepidemiology and pharmaceutical waste (10 min) (SS)

2. Assessing the environmental burden of drug utilization using databases (15 min) (EP)
Key considerations when using registries in studies of pharmaceuticals in the environment. How can these be used in promoting sustainable drug use?

3. Opportunities with primary data collection in environmental research (15 min) (JV)
How can quantitative and qualitative surveys and interviews contribute to better understanding about pharmaceuticals in the environment and strategies forward?

4. Wastewater-based epidemiology - monitoring pharmaceuticals in sewage treatment plants, lakes and rivers (15 min) (BW)
How can analyses of human metabolic excretion products in wastewater and in the environment be analysed to better understanding of the extent of the problem.

5. Panel discussion (30 min) (EnvPE chair, presenters, NN)

A panel representing different continents and EnvPE SIG members will address issues including availability of data, environmental hazard/risk, temporal relationship between drug use and environmental impact, and the value of these studies for decision making.