In long-term care settings, many residents showing signs of a urinary tract infection (UTI) are given a urine dipstick test for confirmation. However, these tests are unreliable in older adults over the age of 65 and often result in unnecessary antibiotic prescriptions. Overdiagnosis of UTIs is one of the most common reasons for the unnecessary use of antibiotics in LTC.

In response to this concern, over ten societies, associations, and organizations have come together to endorse a statement advocating against the use of urine dipsticks in older adults. This collaborative effort aims to reduce the overuse of antibiotics in LTC settings and promote evidence-based best practices.

Reducing unnecessary tests, treatments and procedure can benefit our planet in a variety of ways, including:

Medications 

Medications impact the environment across their lifecycle, spanning production, transportation, use, and disposal. Pharmaceutical manufacturing often involves the use of chemicals, energy, and water. A significant concern is the presence of pharmaceuticals in water bodies from human and animal waste or improper disposal. Wastewater treatment plants may not be equipped to remove these compounds, leaving the presence of pharmaceutical residues in rivers, lakes, and groundwater.

Tests 

Unnecessary testing can contribute to greenhouse gas emissions through equipment operation, energy use, water consumption, manufacturing, and material waste.

With over 1.2 million lab tests performed each day in Canada, laboratories represent a sizable part of the health care system. Lab testing involves single-use materials like tubes, syringes, and pipettes, while laboratories are energy-intensive operations due to specialized equipment, ventilation, and temperature control systems. While many lab tests are needed, some are not and often done routinely or automatically. Unnecessary lab testing can also result in false positives and drive further testing, procedures, referrals, and treatments — all of which produce additional carbon emissions.

Procedures 

Unnecessary procedures impact the environment by creating excess greenhouse gas emissions, consuming resources, energy, and generating waste.

Procedures require patients to travel to their appointments, and this can include travelling by car, bus, train as well as air travel for those in northern and remote communities. These modes of transportation generate greenhouse gas emissions. These emissions could be reduced by foregoing unnecessary tests and procedures and, where available and appropriate, utilizing telemedicine/virtual medicine. Overuse of procedures also creates excess waste. This can include single-use items like needles, syringes, test kits, gloves, gowns and masks, as well as pharmaceutical waste.

There are everyday practices we can stop or reduce that don’t add value to patient care and harm the environment. Choosing Wisely Canada’s climate-conscious recommendations, developed by 20+ clinician societies, aims to improve planetary health without compromising patient care.