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  • 048 Patient perspectives on integrating environmental sustainability into clinical decision-making: an exploratory study in obstetric and gynaecological patients

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048 Patient perspectives on integrating environmental sustainability into clinical decision-making: an exploratory study in obstetric and gynaecological patients
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  1. Eva S Cohen1,2,3,
  2. Dionne S Kringos2,3,
  3. Lisanne HJA Kouwenberg2,3,
  4. Nicolaas H Sperna Weiland3,4,
  5. Cristina S Richie5,
  6. Johanna WM Aarts1,
  7. Wouter JK Hehenkamp1,3
  1. 1Department of Obstetrics and Gynaecology, Amsterdam UMC, Amsterdam, the Netherlands
  2. 2Department of Public and Occupational Health, Amsterdam UMC, Amsterdam, the Netherlands
  3. 3Centre for Sustainable Healthcare, Amsterdam UMC, Amsterdam, the Netherlands 4Department of Anaesthesiology, Amsterdam UMC, Amsterdam, the Netherlands
  4. 5Department of Philosophy, The University of Edinburgh, Edinburgh, Scotland
  5. *Contributed equally to this article and should be considered equal last authors

Abstract

Introduction Healthcare delivery is estimated to contribute 4.6% of global greenhouse gas emissions.1Patients are rarely involved in climate mitigation strategies, although this is pivotal in empowering a population that is already vulnerable to health risks caused by climate change. Patient involvement might also catalyse sustainable health system changes. The aim of this study was to investigate patient perspectives on integrating environmental sustainability into healthcare.

Methods Data for this cross-sectional patient survey were collected between February 28th and May 26th 2023 at the gynaecological outpatient clinics of Amsterdam University Medical Centres, The Netherlands. All patients visiting the benign gynaecology, gynaecological oncology, prenatal diagnostics, obstetrics, or fertility outpatient clinic were eligible for inclusion. Main outcomes included patients’ climate-related knowledge and worry, engagement with environmentally sustainable mitigation strategies in healthcare and willingness to opt environmentally sustainable treatment alternatives. Multivariable linear regression analyses were performed to explore patient characteristics associated with perspectives regarding integrating sustainability into healthcare and clinical decision making.

Results In total, 274 surveys were included in the analysis. Most patients (79%) were worried about the consequences of climate change. Although almost all (91%) found it important to personally contribute to climate protection, they showed hesitance regarding healthcare measures that would impinge on individual choices. The majority (62%) was willing to opt for environmentally sustainable treatment alternatives, but this proportion was dependent upon the medical condition for which patients would seek consultation. Climate-related knowledge and worry were both positively associated with sustainability engagement (p<0.001).

Discussion This exploratory study holds significant implications for the feasibility of integrating sustainability into clinical decision-making and provides a foundation for normative evidence for decarbonizing health care.

Conclusion Gynaecological patients are concerned about climate change and are open to contribute to climate mitigation strategies in healthcare by opting for environmentally friendly treatment alternatives for certain medical conditions.

Reference

  1. Romanello M, Napoli CD, Green C, Kennard H, Lampard P, Scamman D, et al. The Lancet. 2023;0.

https://doi.org/10.1136/bmjebm-2024-SDC.47

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