{
  "abstract": "Objective To identify and prioritise the most appropriate (de)prescribing interventions in inpatient and outpatient hospital care to advance environmentally sustainable healthcare.Design A modified RAND Delphi study.Setting Inpatient and outpatient hospital care in the Netherlands.Participants The Delphi panel consisted of 63 participants, comprising 36 physicians and 27 pharmacists working in Dutch hospitals.Primary and secondary outcome measures Consensus on the appropriateness of (de)prescribing interventions for frequently used medications in inpatient and outpatient hospital care to advance environmentally sustainable healthcare and the prioritisation of interventions per care setting (inpatient/outpatient) and intervention type (deprescribing/sustainable dosage form), culminating in a top 20.Results 51 (de)prescribing interventions were identified for 18 medication classes, for which consensus on appropriateness was reached for 42 (82%). The top 20 highest ranked interventions were identified, starting with switching from intravenous to oral administration of paracetamol, stopping chronically used proton pump inhibitors without indication and initiating antibiotics orally in case of good bioavailability.Conclusions Most (de)prescribing interventions were considered appropriate for advancing sustainable medication use, highlighting support for their potential implementation to reduce the environmental burden of healthcare.",
  "authors": [
    {
      "affiliations": [
        "Department of Adult Intensive Care, Erasmus MC University Medical Centre, Rotterdam, The Netherlands"
      ],
      "name": "Elisabeth Marissa Smale"
    },
    {
      "affiliations": [
        "Department of Adult Intensive Care, Erasmus MC University Medical Centre, Rotterdam, The Netherlands"
      ],
      "name": "Jiske Lianne van der Giessen"
    },
    {
      "affiliations": [
        "Reumazorg Zuid West Nederland, Roosendaal, The Netherlands"
      ],
      "name": "Cathelijne Willemijne Yvonne Appels"
    },
    {
      "affiliations": [
        "Department of Pharmacy, Radboud University Medical Centre, Nijmegen, The Netherlands"
      ],
      "name": "Emiel Leegwater"
    },
    {
      "affiliations": [
        "Department of Internal Medicine, Alrijne Hospital Leiden, Leiden, The Netherlands"
      ],
      "name": "Marlieke Dietz"
    },
    {
      "affiliations": [
        "Department of Clinical Pharmacy, University Medical Centre Utrecht, Utrecht, the Netherlands"
      ],
      "name": "Patricia Maria Lucia Adriana van den Bemt"
    },
    {
      "affiliations": [
        "Department of Pharmacy, Reinier de Graaf Gasthuis, Delft, The Netherlands"
      ],
      "name": "Saskia Coenradie"
    },
    {
      "affiliations": [
        "IQ Healthcare, Scientific Institute for Quality of Healthcare, Radboud University Medical Centre, Nijmegen, The Netherlands"
      ],
      "name": "Rudolf Bertijn Kool"
    },
    {
      "affiliations": [
        "SIR Institute for Pharmacy Practice and Policy, Leiden, The Netherlands"
      ],
      "name": "Henk-Frans Kwint"
    },
    {
      "affiliations": [
        "Department of Pediatric Surgery, Intensive Care Unit, Erasmus MC Sophia Kinderziekenhuis, Rotterdam, The Netherlands",
        "Department of Internal Medicine, Nursing Science, Erasmus MC University Medical Centre, Rotterdam, The Netherlands"
      ],
      "name": "Erwin Ista"
    },
    {
      "affiliations": [
        "Department of Adult Intensive Care, Erasmus MC University Medical Centre, Rotterdam, The Netherlands",
        "Department of Hospital Pharmacy, Erasmus MC University Medical Centre, Rotterdam, The Netherlands"
      ],
      "name": "Nicole Hunfeld"
    }
  ],
  "title": "Advancing sustainable medication use in healthcare: a Delphi study on (de)prescribing interventions",
  "uid": "152473f0-1240-582b-904d-f3384712921e"
}