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Climate Change and Pharmacy - A Place for Everyone

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An overview of climate change and pharmacy

Shellyza Sajwani, MPharm, PharmD

Co-Chair - Canadian Association of Pharmacy for the Environment (CAPhE)

Co-Founder - Climaceutics Health Solutions

Co-Lead – International Pharmaceutical Federation Environmental Sustainability Development Goal

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Why act now??

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The bottom line….

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Overview of the issue

Greenhouse gas (GHG) emissions contribute to more than one-quarter of global deaths from heart attacks, strokes, lung cancer and chronic respiratory disease.
Furthermore, the WHO reports that climate change will result in an additional 250,000 deaths annually between 2030 and 2050 due to malnutrition, malaria, diarrhea and heat stress.
In Canada, more than 20,000 premature deaths each year are attributable to air pollution.
Children, the elderly and those with preexisting medical conditions are among the most vulnerable

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Role of pharmaceuticals

Canadian healthcare GHG emissions are a result of public hospitals (22%), prescribed drugs (21%) and physician services (13%).
Prescribed and non-prescribed pharmaceuticals together represent 25% of the total healthcare GHG emissions, the largest of any category

Airline Industry

Health Systems

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Climate Mitigation Within Pharmacy

Sustainable Procurement AND reducing plastic

Medication Use (Anaesthetic Gases + Inhalers)

Building/Materials & Energy

Operations Processes (within pharmacies) AND reducing plastic

Within mitigation, or the reduction of emissions within healthcare systems, we can think of four broad areas.

First, we know that certain medications have a massive impact to emissions – like certain anaesthetic gases and metered dose inhalers, and pharmacists can be involved in examining alternatives that are therapeutically equivalent

Second, we know that procurement also has a big impact on climate change, so industry pharmacists and pharmacy technicians can look into methods of sustainable procurement

Third, we know that operational pharmacy managers , and those in pharmacy who are more distribution focused can look into streamlining operations processes to make them more sustainable within both a community and hospital setting

When building new campuses or new pharmacies, we can also have a look at energy and building materials, but I won’t talk much about this today as it’s outside the scope of most of us

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Hospital Pharmacy… Mitigation

Sustainable Procurement

Medication Use (Anaesthetic Gases + Inhalers)

Building/Materials & Energy

Operations Processes (within pharmacies)

Deprescribing

Alternatives to MDIs inhalers where clinically appropriate

Anaesthetic Gas Review (sevaflurane v.s. desflurane)

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Climate Adaptation Within Pharmacy

Subject Matter Impacts (Therapeutics )

Disaster Plan Recommendations

Strengthening Supply Chains /Minimizing Shortages

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Disaster Plans

Impacts to evacuees?

Impacts to pharmacy operations?

Impacts to hospital pharmacy running?

PLANNING CRUCIAL

With regards to adaptation – we need to understand and have more data on the impact of heat on medications and medication use. So for example, we need to be able to understand how increased heat waves may affect the use of diuretics and ACE inhibitors in patients with renal function, fluorouracil bottles when patients don’t have air conditioning at home, and lithium when patients are dehydrated – these are just a few areas which are immediately relevant for pharmacists. Pharmacists can also play a massive role within sustainable prescribing, where you think about deprescribing within a new additional lens of sustainability.

We also need to think about the impact impact of natural disasters on supply chain management and ensure that we can think in a prevention based manner. For example, you don’t actually need a natural disaster to affect your country in order for a supply chain to be disrupted. We can also look into information available on disaster plans if patients are not able to access their health system, either because the health system itself or their medical records have been affected by a natural disaster, or cell service is down and communication cannot occur.

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Advocacy and Partnerships…

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Tarek Hussein (He/Him)

PharmD(c), MBA, BScPhm, RPh, C.Mgr., LSSGB, DTM�Clinical Practice in Adaptation Co-Lead

Embracing Social Prescribing

A Pathway to Holistic Sustainable Healthcare

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Objective

Introduce the concept of social prescribing and its role in enhancing holistic healthcare approaches.
Demonstrate how connecting patients with community resources and non-clinical services can lead to comprehensive and holistic well-being.
Advocate for its adoption in healthcare settings.

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Why Social Prescribing?

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Why Social Prescribing?

The County Health Rankings (CHR) model, developed by the University of Wisconsin Population Health Institute in collaboration with the Robert Wood Johnson Foundation
It describes a more holistic view of population health, highlighting multiple factors and their relative contributions to the length of life (as measured by premature death) and quality of life (as measured by low birth weight and poor mental or physical health)

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Why Social Prescribing?

It is estimated that around 80% of health and wellbeing is determined by non-medical factors

(Magnan, 2017, Malby et al. 2019)

It is estimated that up to 50% of primary care visits are for non-medical issues

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Why Social Prescribing?

(National Academies of Sciences, Engineering, and Medicine, 2019)

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What Is Social Prescribing?

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What is Social Prescribing?

Social prescribing is “a means for trusted individuals in clinical and community settings to identify that a person has non-medical, health-related social needs and to subsequently connect them to non-clinical supports and services within the community by co-producing a social prescription – a non-medical prescription, to improve health and wellbeing and to strengthen community connections.”

- Muhl et al. (2022)

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What is Social Prescribing?

Social Prescribing for Climate Resilience: Connecting People to Nature and Community Ayesha Asaf, MPH Candidate; Catherine Macdonald; Sonia Hsiung; Kate Mulligan, PhD

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https://www.allianceon.org/sites/default/files/documents/social_prescribing_2_pager_infographic_final_17may2022.pdf

What is Social Prescribing?

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The Impact of Social Prescribing

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The Impact of Social Prescribing

The Alliance for Healthier Communities recently embarked on Canada’s first social prescribing pilot (2018-2020)
Over 1100 clients from 11 community health centres across Ontario received a total of nearly 3300 social prescriptions

(Alliance for Healthier Communities, 2020)

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https://www.allianceon.org/sites/default/files/documents/social_prescribing_2_pager_infographic_final_17may2022.pdf

The Impact of Social Prescribing

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The Impact of Social Prescribing

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The Impact of Social Prescribing

“In the 30 years I have spent as a family doctor, social prescribing represents the most effective, wide reaching, and life changing of all initiatives to date.”

- Dr. Marie Anne Essam (2021)

(Global Social Prescribing Alliance, 2021)

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