NEWS & OPINION EWAP MARCH 2024 39 Contact information Grodsky: grodskylsu@gmail.com Palmer: dpalmermd@comcast.net Drug waste and how physicians can move the needle at their institutions Drug waste in healthcare is a critical concern. In this context and within ophthalmology, perioperative eye drop use is an important issue on which we can make a significant impact in reducing waste. 1 Our particular focus is on perioperative eye drop waste, emphasizing the pivotal role physicians play in recognizing the issue and driving tailored solutions for ophthalmic care. A common theme among most intraocular surgeons is the need for perioperative ocular anesthesia, dilation, and infection prevention. This is often achieved via administration of different types of eye drops. Unfortunately, at some institutions and ASCs, these drops are used once and discarded, requiring a new bottle for the next patient. The cost of eye drop waste and related carbon emissions produced annually is astronomica l,2,3,4 especially at high-volume centers. Patients may find repurchasing these same medications for continued postop care financially and logistically challenging. As a result, we, like so many of our colleagues, advocate for and educate others on the recommendations of a multisociety position paper 1 calling for: 1) multidose eye drop use on multiple patients up to the manufacturer expiration date using CDC infection control guidelines, and 2) facilities to allow taking home partially used topical OR medications for postop use when indicated. We have learned that every institution or ASC is different and has differing rationales to support their policies regarding multiuse eye drops. These can include concerns about sterility and patient safety, government-mandated programs like Section 340B, state laws prohibiting multidosing eye drops, or simply an unchallenged longstanding policy. Nevertheless, the non - alignment between manufacturer labeling and actual practice underscores the need for a closer examination of existing protocols and addressing waste without compromising patient care. Here, we outline a proactive approach for physicians to drive change within their institutions and ORs, emphasizing the importance of persistence, open dialogue, interaction with state eye and medical societies, and a commitment to sustainability. 1. Observation and analysis: When physicians observe daily practices with a keen eye toward sustainability, there are bound to be many identified situations where a positive change can be made, such as if eye drops are being used as single-use instead of multiuse and/or patients are not allowed to bring their partially used topical OR medications home. 2. Engage in constructive dialogue: Armed with observational insights, physicians should initiate conversations with colleagues, nursing staff, administrators, pharmacists, and state eye and medical societies to determine if facility policies are local or statewide. This dialogue should aim to uncover the reasons behind the current practices and shed light on any concerns that contribute to waste. This might involve revisiting guidelines for drug usage, storage, and disposal, or even investigating and challenging state or national policies. If no such regulatory policy exists, the AAO Topical Medical Waste Reduction Act legislative template is a good starting point to initiate change. It’s essential to approach these discussions with an open mind, seeking to understand issue complexities. 3. Challenging the status quo: A common eminence-based refrain of “That’s just the way it is” can often hinder progress. Physicians should persistently question the status quo, asking why certain practices are in place and whether they align with best practices and sustainability goals. It takes courage by Jake Grodsky, MD, and David Palmer, MD This article originally appeared in the December 2023 issue of EyeWorld. It has been slightly modified and appears here with permission from the ASCRS Ophthalmic Services Corp.
RkJQdWJsaXNoZXIy Njk2NTg0