Hospital admissions increase the number of patients’ medications. Medications cause a significant amount of the carbon footprint from healthcare.  General Practitioners provide continuity of therapeutic care after discharge including re-prescribing, in their role as the major prescribers of medicationsEvaluate the climate impact of common cardiovascular, antimicrobial, and antidepressant drugs prescribed at discharge from a large hospital over 10 years, as well as changes over time Discover the usefulness of the Yewmaker website for prescribing decisions Balance clinical efficacy with environmental impact when choosing equivalent drug options with lower carbon footprint.Ten years of discharge prescriptions data from a large hospital for the commonest antidepressants, cardiovascular and antimicrobial drugs, and detected trends, will be assessed. The planetary impact will be assessed using the YewMaker Medication Carbon Footprint (MCF)  Changing high-MCF medications to lower-impact MCF will be explored in YewmakerThe anticipated climate impact of discharge medications is expected to show an increase. Data analysis will be in early 2026 to identify which drugs are the greatest contributors. Most discharge medications have high MCF ratings.  Resources show lower MCF equivalents are available.  Many antidepressants and antibiotics have high MCF ratings, conversely many cardiovascular drugs have lower MCF ratings, but with little variation amongst equivalents. Yewmaker is an easy-to-use resource with a focus on MCF rating only.Reducing the environmental footprint of discharge medications and medications in general needs a multifaceted approach.  The assessment of MCF rating is made far easier by the use of Yewmaker, but additional resources are needed to guide lower MCF choice of clinical equivalence. The expertise and patient centred position of the General practitioner is a critical part of this process and likely to be pivotal to the introduction of bioequivalent lower MCF medications.Information about trends in discharge medications and the resulting carbon footprint is important to understand.  This informs drug changes based on MCF ratings, to reduce the harms to the environment from healthcare.  Patient preferences, rational prescribing and deprescribing are important additional factors to use in addition.

The crossing of planetary boundaries linked to human activities represents an increasingly serious threat to the health of populations and individuals. It is necessary to address the issue of the impact of healthcare on the environment, which is a pressing concern in the profession. The planetary health working group of XXX is working to develop tools to facilitate the integration of planetary health into the daily practice of general practitioners. The aim of this work was to draft a practical guide bringing together the different aspects of planetary health in general medical practice and the tools already available.This is a qualitative collective work based on a narrative review of the literature. A specific working group was set up to work on the issue and validate relevant information by consensus, based on the most recent scientific evidence.At first glance, it may seem difficult to add yet another element – planetary health – to everything that general practitioners already have to do within the limited time available for a consultation. That is precisely the purpose of this practical guide: a gradual, step-by-step integration, starting with what is easiest for both the doctor and the patient, as part of a comprehensive approach focused on prevention.General practitioners are recognised as role models at both the community and individual levels. Professional organisational choices and healthcare practices have an impact on the environment and send a potential message of commitment to planetary health. This practical guide is useful because it provides a roadmap for integrating planetary health into consultations. It encourages reflection on all areas of our practices that are relevant to planetary health.Integrating planetary health into consultations is one of the solutions for limiting the impact of the healthcare system while improving individual and collective health through co-benefits.

In response to the growing urgency for sustainable practices in primary healthcare (PHC), a collaborative initiative among European general practitioners (GPs) has been launched. Climate change is increasingly impacting global health, while healthcare itself contributes 4-6% of global CO2 emissions, of which general practice is a notable contributor. To address this issue, a European collaborative study on sustainability in PHC was initiated with support of EGPRN. The study considers various dimensions of sustainability including energy conservation, eco-friendly medical devices, reduction of disposable materials, and the promotion of alternative transportation methods such as cycling for home visits.To explore the current opinions and ongoing interventions related to environmental sustainability among European GPs.This mixed-methods project includes two phases. First a cross-sectional survey is being conducted among GPs from European countries, to provide an overview of sustainability practice and attitudes. In the second phase qualitative interviews with GPs in selected countries will explore priorities, relevant experiences and feasible implementation strategies for environmental sustainability.Surveys are distributed in 10 countries. Preliminary analysis of 1214 responses, shows that 77 % strongly agree, and 19 % agree to some extent that sustainability in PHC is important. However, only 26% reported the existence of a national sustainability policy for PHC in their country. The highest rated and most feasible actions include reducing electricity consumption, longer use of medical equipment and reducing waste. In contrast, reducing medical consumables, reducing staff mobility and decreasing reliance on internal/external laboratory analyses are considered less important and more difficult to implement. 87% of the respondents gave one or more examples of actions in their practice.Results of this survey clarify GPs’ perspectives across countries and show a high attention to sustainability and actions already taken up.The findings will help identify gaps and define objectives for future research.

Diet is a key factor in human health and has a significant impact on our environment. Promoting sustainable diets generates co-benefits for both health and the environment. General practitioners, who play a key role in prevention, could use an educational tool to help patients make more sustainable food choices.Creation and qualitative evaluation of an information resource on sustainable eating for patientsThe content of the resource is based on a review of the literature on the co-benefits of a sustainable diet for health and the environment, as well as on recommendations from various official bodies. It was validated using a Delphi method, in accordance with guidelines and Campbell criteria. The readability and acceptability of the booklet were assessed through semi-structured interviews with patients.The resource presents 50 recommendations for a sustainable diet, validated by 12 experts through three rounds of a Delphi process conducted in 2024. The interviews revealed that its acceptability depended on factors such as participants’ knowledge, individual perceptions, and socio-demographic profile. The “traditional” diet was perceived as balanced and was often associated with a rural identity and local terroir products. The notion of “appropriate consumption” of animal-based products was rarely questioned; it remained abstract and closely linked to individual representations. The detrimental effects of meat consumption on health and the environment were poorly understood. Sustainable diets were perceived as restrictive and complex, requiring a long and difficult process of change and more specific knowledge.Recent research shows that patients recognize the impact of climate change on their health, but do not fully appreciate the impact of diet on the environment. Although the resource sometimes lacked clarity on certain concepts, it helped enhance participants’ knowledge and initiated reflection on their dietary practices.This study led to the development of an initial informational booklet, which appears to be a relevant tool for facilitating discussions with patients about the links between diet, health, and environmental impacts. This work suggests that tailoring messages to different individual representations would maximize adherence to the topics addressed. Future interventional studies would be needed to test and refine these adaptations in real-world conditions.

Healthcare accounts for about 8% of France’s greenhouse gas (GHG) emissions, with medicines representing the largest share (9.1 Mt CO₂eq annually). For general practitioners, prescribing is a daily core activity and a major lever for reducing environmental impact. Yet actionable, quantifiable prescribing principles remain scarce. This study aims to identify simple, reproducible eco-prescription principles that maintain the quality of care while lowering the carbon footprint of commonly used medicines.To quantify the environmental impact of therapeutic choices within and across drug classes and to derive practical eco-prescription principles applicable in general practice.We conducted (1) a review of existing recommendations from national/international institutions and scientific societies, and (2) a quantitative analysis of the Ecovamed® database, which provides life-cycle–based carbon footprints for 12,316 oral medicines, extended to selected parenteral forms. Nine commonly prescribed therapeutic classes were analyzed using the Defined Daily Dose (DDD) as functional unit, standardized on a one-month treatment package. Additional analyses explored combined formulations and dosing schemes. The proposed principles were then validated by a multidisciplinary working group of over 100 professionals (physicians, pharmacists, nurses, academics, patient associations).Five quantitative principles emerged: 1- Prefer dry oral forms over liquid or parenteral formulations (GHG reductions ×2 to ×130). 2- Avoid pressurized inhalers when clinically appropriate (reduction ×10 to ×20 compared with dry-powder devices). 3- Within each therapeutic class, choose the molecule with the lowest DDD (average reduction 29%; up to 48% in some classes). 4- Prefer combined formulations over separate active substances (average reduction 27%). 5- Favor regimens minimizing the number of units administered (mean reduction 37%). These principles showed no increase in reimbursement cost in the comparative example.Eco-prescription offers high-impact, low-cost opportunities for reducing practice-related emissions. Its implementation must remain consistent with clinical guidelines, patient-specific factors (e.g., age, swallowing capacity, inspiratory flow), and safety considerations. Organizational constraints may limit some substitutions in hospital settings, but application in ambulatory care is broad.Quantified eco-prescription principles can guide GPs toward lower-carbon therapeutic choices without altering care quality. They form a pragmatic foundation for integrating environmental sustainability into everyday prescribing. Submitted on behalf of the full eco-prescription working group.

The ecological transition challenges current definitions of care quality in a context where healthcare systems themselves contribute to environmental pressures. Primary care, situated at the intersection of individual needs and collective responsibilities, provides a unique setting to explore the conditions for “sober care”.To explore how primary care professionals working in multidisciplinary primary care centres (maisons de santé pluriprofessionnelles, MSPs) perceive, experience, and anticipate the implementation of environmentally sober care.A qualitative study based on a grounded theory approach was conducted. Six focus groups were organised across six MSPs located in six different departments, reflecting diverse territorial contexts. Thirty-eight professionals from multiple disciplines participated. All interviews were audio-recorded, transcribed verbatim, independently double-coded by two researchers, and triangulated. Thematic saturation was reached during the fifth focus group and confirmed by the sixth.Three categories emerged from the analysis. First, environmental sobriety appears as an emerging yet imprecise concept. Although associated with reduction or simplification, participants found it difficult to translate into practice due to the absence of reliable indicators. They consistently expressed a need for data, scales, and evidence to guide and legitimise decisions. Second, implementing sober care generates tensions within clinical activity. Professionals described navigating between their intention to reduce environmental impacts, perceived patient expectations, and their responsibility to maintain care quality and preserve the therapeutic relationship. Third, territorial context strongly shapes what sober care can realistically become. Local infrastructure, transport conditions, organisational cultures, and care pathways create both constraints and opportunities.Professionals described how the absence of ecological indicators in primary care leaves them without the evidence they consider necessary to guide or justify environmentally oriented decisions. Their narratives reveal a subtle negotiation between personal ecological aspirations and the clinical, relational, and organisational responsibilities that structure everyday practice. Beyond these tensions, sobriety gradually emerges as a renewed conception of care quality, emphasising relevance, appropriateness, and thoughtful adaptation to local contexts over restriction.Environmental sobriety emerges as a new dimension of care quality in primary care. Developing ecological indicators, supporting professional training, and incorporating environmental reasoning into routine practice may facilitate a transition toward sustainable models of care.

Health systems generate 4–5% of global greenhouse gas (GHG) emissions, and in France, community-based primary care accounts for nearly one quarter of the national health-sector footprint. Yet the environmental impact of primary care remains insufficiently characterised and seldom examined from the perspective of everyday clinical practice. As ecological transition becomes a strategic priority it is essential to clarify the most significant sources of emissions in order to identify levers that are both clinically relevant and territorially adapted.To synthesise convergent findings from the international literature on the carbon footprint of primary care and to highlight the clinical and organisational levers most pertinent to ecological transition in general practice.Systematic review registered in PROSPERO (International Prospective Register of Systematic Reviews).Searches were conducted in MEDLINE, EMBASE, Web of Science and grey literature. We included quantitative studies reporting GHG emissions in primary care settings. Data extraction and quality assessment were performed independently by two reviewers. Nine quantitative studies were included in the final synthesis.Across these nine studies, a coherent picture emerges. Medicines consistently appear as the dominant source of emissions, with Scope 3 activities those indirect emissions linked to care pathways accounting for at least seventy percent of the overall footprint. The choice of inhaler proves to be a particularly powerful clinical lever. The carbon impact of a consultation ranges from 4.8 to 10.5 kgCO₂e, while emissions attributable to buildings remain modest. Patient travel constitutes a second, but context-dependent, contribution: it becomes particularly significant in rural areas where long distances and car dependency amplify the environmental burden. Teleconsultation, finally, offers environmental benefits only when it replaces a real and substantial journey.Despite marked heterogeneity in methodology and scope across studies, these convergences are robust and align with international calls to address the ecological impact of healthcare by focusing not on technology or infrastructure but on clinical decision-making and the organisation of care. Evidence remains especially scarce for nursing, physiotherapy and other allied health professions.Ecological transition in primary care depends chiefly on clinical practice and territorial organisation. This synthesis offers a practical and operational framework to guide the decarbonisation of general practice.