Professional practice guidelines: eco-responsible optimization of choice and use of drugs and medical devices in operating theaters or interventional sector - 26/05/26

Doi : 10.1016/j.accpm.2026.101772

Delphine Cabelguenne ^a, Hélène Beloeil ^b, Aurelie Bros ^c, Pierre Cassier ^d, Claire Chapuis ^e, Benoit Chauveau ^f, Assia Daikh ^g, Cédric Dananché ^h, Lise Durand ⁱ, Martin Dupuy ^j, Florence Lallemant ^k, Christophe Lambert ^l, Abir Petit ^m, Mathieu Pioche ⁿ, El Mahdi Hafiani ^o, Patrick Pessaux ^p,⁎

by Collectif d’Ecoresponsabilité en Santé (CERES) and Association Française de Chirurgie (AFC)

Euro-Pharmat-Société Pharmaceutique Française des Dispositifs Médicaux (Euro-Pharmat-SPFDM)

Société française d’Anesthésie et de Réanimation (SFAR)

Société Française de Chirurgie Rachidienne (SFCR)

Société Française d’endoscopie Digestive (SFED)

Société Française d’Hygiène Hospitalière (SF2H)

Société Française de Pharmacie Clinique (SFPC)

Société Française de Radiologie (SFR)

Société Française des Sciences de la Stérilisation (SF2S)

^a Quality Department, Le Vinatier Psychiatrie Universitaire Lyon Métropole, Bron, France

^b Anesthesia and Intensive Care Department, CHU Rennes, Université de Rennes, Inserm OSS 1242, CIC 1414, Rennes, France

^c Service Pharmacie-Stérilisation, Hopitaux Universitaires de Strasbourg, Strasbourg, France

^d Institute of Infectious Agents, Hospices Civils de Lyon, Lyon, France, CIRI, Centre International de Recherche en Infectiologie, Université de Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, Lyon, France

^e Service de Pharmacie Clinique, Pôles Pharmacie et Anesthésie-Réanimations, CHU Grenoble Alpes, France

^f Radiology Department, CHU Estaing Clermont Ferrand, Clermond Ferrand, France

^g Service Dispositifs Médicaux, Pôle Pharmacie, CHU Grenoble Alpes, France

^h Service Hygiène, Épidémiologie, Infectiovigilance et Prévention, Hospices Civils de Lyon, France, CIRI, Centre International de Recherche en Infectiologie, Université de Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, Lyon, France

ⁱ Pharmacy Department, Clinical Pharmacy Unit, CHU Rennes, Rennes, France

^j Department of Neurosurgery, Clinique de l'Union, Toulouse, France

^k Service des Urgences Chirurgicales et Déchocage, Hôpital Salengro, CHRU Lille, Lille France

^l Stérilisation Centrale, CH Métropole Savoie, Chambery, France

^m Secteur des Dispositifs Médicaux Stériles, Pôle Pharmacie, CHU Amiens, France

ⁿ Endoscopy, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France

^o Groupe des Anesthésistes Réanimateurs de l'Hôpital Privé d'Antony, Antony, France

^p Service de Chirurgie Viscérale et Digestive, Nouvel Hôpital Civil, Strasbourg, Inserm U1110, France

^⁎ Corresponding author.

Abstract

Objectif

To provide recommendations for eco-responsible optimization of choice and use of medicines and medical devices.

Design

A committee of 16 experts brought together by CERES and from SPFDM/Euro-Pharmat, SFAR, SFCR, SFED, SF2H, SFPC, SFR, SF2S has been set up. A policy for declaring links of interest was applied and respected throughout the process of creating the reference system. Similarly, it has not provided any funding from a company marketing a health product (drug or medical device). The committee had to respect and follow the GRADE® method (Grading of Recommendations Assessment, Development and Evaluation) to assess the quality of the evidence on which the recommendations were based.

Methods

The recommendations were formulated by identifying 4 different fields: practice of care (optimization of medicines and medical devices), packaging (reduction of the environmental impact of medical devices), organization of care (integration of environmental criteria) and waste management (reduction, sorting and recovery). Each question was formulated according to the PICO (Patients, Intervention, Comparison, Outcome) format. The analysis of the literature and the recommendations were carried out according to the GRADE® methodology.

Results

The experts’ synthesis work resulted in 46 recommendations validated after one round of voting. For all questions, since the GRADE grid ® method could not be applied in full, the recommendations were formulated in the form of expert opinions.

Conclusion

From a strong agreement between experts, we were able to formulate 46 recommendations for eco-responsible optimization of the choice and use of medicines and medical devices.

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Keywords : Recommendation, Sustainable development, Operating room, Environmental impact, Interventional sector, Medicines, Drugs, Medical devices, Ecological design of care, Packaging