Keywords: planetary health, quality improvement, primary care, rural health

Background:

WONCA Europe revised its definition of Family Medicine in 2023 including planetary health. Climate change is described as a global health emergency. The effects of climate change and/or the requirements to address issues like loss of biodiversity and intensive agriculture are directly felt in rural areas. Challenges to reduce the carbon footprint of delivering primary care in rural areas can be perceived as intractable e.g. due to longer travel times and a workforce under pressure.

Aim of the study:

At last year’s EURIPA Rural Forum a rolling initiative titled ‘Taking the pledge for Planetary health’ was launched. Delegates were asked to implement a small sustainable quality improvement project and were supplied with an easy-to-follow step-by-step guide. The projects were: 1.Reduce the use of Short-Acting Beta-Agonists (SABA) inhalers, 2. Reduce metered dose inhalers (MDIs), 3. Reduce polypharmacy, 4. Increase non-pharmacological management, 5. Reduce investigations and referrals. The aim of the overall project is to increase the awareness of planetary health among rural primary healthcare practitioners and to capture how small positive steps can have great impact when done at scale.

Methodology:

Quality improvement

Results:

17 delegates signed up to ‘the pledge for planetary health’. The majority (14) chose to reduce polypharmacy. Feedback collected indicates that most projects are still ongoing 6 months after starting, and the main difficulty people have encountered is the buy-in of others and a limitation in resources mainly time.

Conclusions:

Planetary health is something which should be part of common good practice. This project shows a commitment to engage with sustainable quality improvement. This is a rolling project and delegates at future EURIPA conferences will be encouraged to ‘take the pledge for planetary health’. It is envisioned that when more primary care teams get involved doing small SusQI projects requiring minimal effort it could reduce the carbon footprint of rural primary care significantly.