Decarbonizing healthcare: The path to sustainable medicine
As the effects of climate change become more apparent, we are recognising impacts on the health of millions of people in addition to more frequent extreme weather events and loss of biodiversity. We are also increasingly aware that healthcare and research contribute significant global greenhouse gas emissions, so there is an urgent challenge to balance high-quality, equitable healthcare and research with environmental sustainability to reduce their climate impact.
Measuring and reducing healthcare emissions
In our recent study, we performed a secondary modelling analysis of the CREDENCE trial, a big global randomised trial looking at the impact of an SGLT2 inhibitor medication in patients with kidney disease and diabetes. Hospitalisations, cardiovascular events, and kidney failure were all reduced with treatment during the trial, so we wondered whether this would translate to a reduction in the environmental impact from the care pathways for those patients.
We applied greenhouse gas emissions estimates to different aspects of the trial, including: emissions associated with production of the medication, emissions estimates for inpatient hospitalisations and for patients who needed maintenance dialysis. We modelled these estimates with data from the trial to calculate whether there was an overall reduction in greenhouse gas emissions associated with treatment during the trial and found that the greenhouse gas emissions from producing the medication were outweighed by the savings accrued from reducing admissions to hospital and the number of patients requiring dialysis for kidney failure.
Key takeaways
Two important take-aways:
- This research is an example of how we can measure the greenhouse gas emissions associated with interventions in clinical trials. As we move forward, it's vital that we understand the greenhouse gas emissions and environmental impact of the treatments and interventions we are testing, and this work shows how that could be done. It highlights the need to incorporate these assessments into trial design to make sure all the necessary data is captured, and that collaboration is critical to ensure research efficiency - sharing methodologies and repositories of data to facilitate this work.
- Preventative medicine, in this case the use of SGLT2 inhibitors but more broadly adopting guideline directed therapy early in patients’ management, is likely to be a valuable tool in reducing the carbon footprint of healthcare. We know that preventing the development of comorbidities and progression of disease is better for patients and can be beneficial from a cost perspective, and now this research suggests that it could also have a planetary benefit.
Keeping the planet in focus
Overall, the intention of this research is to identify ways to prioritise the planet in healthcare and research without compromising quality of care. Raising awareness for healthcare professionals and researchers so that the planet, and protection of the planet, is at the forefront of our minds will hopefully help reduce the environmental impact of our work.
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Read the full paper: The potential for reducing greenhouse gas emissions through disease prevention: a secondary analysis of data from the CREDENCE trial - ScienceDirect
About the author
Ben Talbot, Research Fellow, The George Institute for Global Health
Ben is a nephrologist and clinical research fellow in the Cardiovascular Division of The George Institute for Global Health. He has worked in clinical medicine in both the UK and Australia and completed a PhD at the University of New South Wales investigating different data approaches to improving global chronic kidney disease treatment and outcomes. Ben’s current program of research focuses on better understanding how to measure and reduce the carbon footprint of health interventions and clinical research, with the long-term goal of contributing to the decarbonisation of healthcare. Ben is currently based in the UK and holds a conjoint senior lecturer position at the University of New South Wales, Australia.