CG4 – Provision of clinical and medicines guidelines

Having access to current, evidence-based medicines information and clinical and emergency care guidelines enables practitioners to undertake best practice prescribing of medicines based on community and patient demographics.

The healthcare sector is a significant contributor to carbon emissions, medical waste, and resource consumption. Encouraging sustainable practices helps reduce this impact while maintaining high-quality patient care. Choosing required treatments wisely and reducing the number of unnecessary tests and procedures are effective steps in reducing a practice’s carbon footprint.

Antimicrobial resistance is a significant and growing global health issue that needs to be addressed in a unified and strategic manner.

The practice could:

• subscribe to guidelines and standards
• provide members of the clinical team with access to free services
• maintain a current version of clinical software databases that include drug guides, Consumer Medicine Information (CMI), medical dictionaries, coding classifications, and information about consumer medicine.

The practice can support members of the clinical team to adopt clinical practices that are environmentally sustainable without imposing requirements on the clinical team. The practice could:

• provide evidence-based, non-prescriptive resources that incorporate sustainability principles, such as the Australian Asthma Handbook and RACGP guidance on reducing the carbon footprint of inhalers
• promote awareness of low-value care, and support clinicians to access decision-support tools that help reduce over-investigation, overdiagnosis and overtreatment
• facilitate access to guidelines and training addressing first-line non-pharmacological management options, such as lifestyle interventions and behavioural therapies
• support medication reviews and deprescribing initiatives, in order to address polypharmacy
• provide evidence-based comparisons of therapeutic goods, for consideration when making treatment decisions
• provide checklists or quick guides for common clinical scenarios, (for example, when to use reusable vs. single-use personal protective equipment (PPE), ways to reduce waste when prescribing)
• promote sustainability topics in CPD activities and team discussions
• include sustainability principles in clinical CPD activities and team discussions
• adopt prescribing software with default options that prioritise sustainability where clinically appropriate (for example, using e-scripts instead of paper).

To support climate-resilient clinical practices, the practice could:

• facilitate access to climate-informed training (for example, managing patients during heatwaves, air pollution events, thunderstorm asthma, floods, storms)
• provide resources about the symptoms, investigations and treatment of infectious diseases that are emerging due to climate change
• support clinicians to integrate patient risk assessments for climate-related health impacts
• encourage use of telehealth and continuity strategies during climate emergencies
• share local alerts and public health guidance about climate-related situations, such as bushfire smoke and extreme heat.

Providing the clinical team and patients with information and resources in order to reduce inappropriate prescribing of antibiotics can help to:

• maintain the effectiveness of antibiotics
• prevent the emergence of antimicrobial resistance
• decrease preventable healthcare-associated infection.

The practice needs to:

• provide members of the clinical team with access to information to reduce the inappropriate prescribing of antibiotics
• provide patients with information about antimicrobial resistance and the appropriate prescribing of antibiotics and other drugs (for example, on the practice’s website, a digital display, social media posts that could include posts from other healthcare organisations)
• display QR codes that link patients to this information
• consider how the practice can encourage each GP to reflect on their own patterns of prescribing and patient care, and to compare them to that of the other GPs in the practice
• use consumer fact sheets to facilitate shared decision-making relating to the use of antibiotics (see CG3 – Facilitating complete patient health records for information on shared decision-making).