Treatment of iron deficiency (with or without anaemia) is an area where clinicians can implement updated recommendations on dose and frequency of iron supplementation that can have a clinical benefit for patients and also help mitigate environmental harms from healthcare practices.
Production and use of medications represent 12-25% of the greenhouse gas emissions from healthcare, the largest item in the supply chain with respect to carbon footprint.12 An accessible entry point for clinicians to reduce their environmental impact is to focus on optimising prescribing.
Iron deficiency is a continuum that starts with iron depletion from the body’s stores, which can progress to anaemia. Iron deficiency affects an estimated 2 billion people and is one of the leading risk factors for disability and death worldwide.3 The British Society of Gastroenterology recently updated its guidelines for management of iron deficiency anaemia.4 Recommendations now include dosing iron once daily or on alternate days instead of two to three times daily.4 These changes provide an opportunity for clinicians to reassess how they prescribe iron supplements and to include environmental considerations in their thought process. Few systematic analyses are available that consider the environmental impact of the medication life cycle, but clinicians can treat patients and reduce their carbon footprint by prescribing fewer medications along with ordering fewer …