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. 2025 May 14;78(2):e3707.
doi: 10.4212/cjhp.3707. eCollection 2025.

Exploring the Views of British Columbians Regarding the Environmental Impact of Medication Use

Madison Lai  1 , Karen Dahri  2 , Gigi Wong  3 , Michael Legal  4
Affiliations

Exploring the Views of British Columbians Regarding the Environmental Impact of Medication Use

Madison Lai et al. Can J Hosp Pharm. .

Abstract
in English, French

Background: Pharmaceuticals affect planetary health through environmental contamination from human excretions, improper drug disposal, and greenhouse gas emissions, derived from manufacturing as well as from use. Research suggests that patients will choose environmentally friendly options for minor ailments, but not severe conditions. To date, no Canadian research has explored patients' views on this topic.

Objectives: To characterize the views of British Columbians regarding medication-related environmental sustainability and to determine how these views relate to medication decisions.

Methods: A web-based survey was distributed across British Columbia from October 30, 2023, to February 29, 2024. Residents of British Columbia at least 18 years of age who could complete an online survey in English were eligible to participate. Descriptive statistics and thematic analysis were used.

Results: A total of 255 responses were received. When presented with a scenario related to stroke, more than half of respondents (51%) preferred the medication with higher efficacy and greater environmental harm; in contrast, for scenarios involving the common cold and asthma, more than half chose the medication with lower efficacy and lower environmental harm (54% and 59%, respectively). When cost was introduced, only 54% stated they would choose the more environmentally friendly medication if it was more expensive, whereas 97% would do so if it was less expensive. Themes from open-ended questions focused on cost, manufacturer considerations, and education.

Conclusions: Respondents were willing to choose the environmentally friendly medication for less serious conditions, but not for conditions perceived as life-threatening and/or debilitating. Cost may be a barrier to accessing environmentally friendly options. Public education opportunities may help to inform more sustainable choices. Additionally, there may be value in manufacturer regulations or policies to ensure that the environmental impact of medications is considered.

Contexte: Les produits pharmaceutiques influencent la santé de la planète par la contamination de l’environnement due aux excrétions humaines, par l’élimination inadéquate des médicaments et par les émissions de gaz à effet de serre, provenant à la fois de la fabrication et de l’utilisation des produits. Des recherches indiquent que les patients choisiront des options écologiques pour des affections mineures, mais pas pour des problèmes graves. À ce jour, aucune recherche canadienne n’a exploré l’opinion des patients à ce sujet.

Objectifs: Caractériser les opinions des habitants de la Colombie-Britannique concernant la durabilité environnementale liée aux médicaments et la manière dont leurs opinions influencent leurs décisions concernant les médicaments.

Méthodologie: Un sondage en ligne a été distribué en Colombie-Britannique du 30 octobre 2023 au 29 février 2024. Les résidents de la Colombie-Britannique âgés d’au moins 18 ans pouvant remplir un sondage en ligne en anglais étaient admissibles à y participer. Des statistiques descriptives et une analyse thématique ont été utilisées.

Résultats: Au total, 255 réponses ont été reçues. Lorsqu’un scénario lié à un accident vasculaire cérébral (AVC) leur a été présenté, plus de la moitié des participants (51 %) préféraient le médicament plus efficace, mais ayant aussi un plus grand impact environnemental; en revanche, pour les scénarios impliquant le rhume et l’asthme, plus de la moitié ont choisi le médicament ayant une moindre efficacité et un impact environnemental moins important (54 % et 59 %, respectivement). Lorsque le coût a été ajouté aux scénarios, seulement 54 % ont déclaré qu’ils choisiraient le médicament plus respectueux de l’environnement s’il était plus cher, tandis que 97 % le feraient s’il était moins cher. Les thèmes des réponses aux questions ouvertes portaient sur le coût, les considérations relatives aux fabricants et l’éducation.

Conclusions: Les participants étaient prêts à choisir des médicaments respectueux de l’environnement pour des affections moins graves, mais pas pour des problèmes perçus comme menaçant la vie ou débilitants. Le coût pourrait constituer un obstacle au choix des options écologiques. L’information du public pourraient aider à l’éclairer sur des choix plus durables. De plus, il pourrait être utile d’instaurer des réglementations ou des politiques pour les fabricants afin de s’assurer que l’impact environnemental des médicaments soit pris en compte.

Keywords: environment; medication choice; medication preference; patient perception; sustainability of medications.

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Conflict of interest statement

Competing interests: For activities and projects not directly related to the study reported here, Karen Dahri has received grants from the Canadian Institutes of Health Research, the University of British Columbia (UBC) Students as Partners Fund, and the BC Ministry of Health; consulting fees from TRC Healthcare; honoraria from Pear Tree Healthcare, the Association of Faculties of Pharmacy of Canada, UBC Continuing Pharmacy Professional Development, and BC primary care pharmacists; and support for travel related to her role as the BC delegate for the Canadian Society of Hospital Pharmacists (now the Canadian Society of Healthcare-Systems Pharmacy [CSHP]). For activities and projects not directly related to the study reported here, Gigi Wong has received honoraria from UBC Continuing Pharmacy Professional Development, the Canadian Policy and Science Conference, and the Pharmacy Technician Society of British Columbia; serves on or advises the CSHP Sustainability Task Force, the Fraser Health Planetary Health Steering Committee, the Greencare network, and the Canadian Coalition for Green Health Care; and has contributed to resources for CASCADES (Creating a Sustainable Canadian Health System in a Climate Crisis) Canada. No other competing interests were declared.

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