The environmental sustainability implications of contrast media supply chain disruptions during the COVID-19 pandemic: A document analysis of international practice guidelines

Natembeya, M.C.; Anudjo, M.N.K.; Ackah, J.A.; Osei, M.B.; Akudjedu, T.N.

Abstract

Introduction
Travel restrictions implemented during the acute phases of the COVID-19 pandemic disrupted supply chain for critical radiology consumables including contrast media (CM) leading to shortages. Consequently, some departments had to restructure their clinical workflows in accordance to recommended guidelines to ensure safe continuity of patient care. This study aimed to summarise the temporary crisis-driven recommendations with implicit environmental sustainability essence and to analyse how these measures might inform the development of a more sustainable, long-term clinical guideline for safer and cost-effective CM usage without compromising diagnostic quality.
Methods
Documents were obtained through an electronic database search together with a relevant manual search in Google Scholar and relevant reference lists. The selected documents were subjected to a pre-defined eligibility criteria for inclusion. The READ approach was employed for document analysis and a thematic analysis of the obtained data was conducted.
Results
Of the 17 documents included, 70% (n = 12) emanate from the United States of America. The summary of the findings relate to minimising CM usage through strategic clinical approaches including optimisation of CM volumes, prioritisation of non-contrast imaging and/or alternative imaging depending on patient need without compromising diagnostic quality.
Conclusion
Critical lessons of sustainability essence are implicitly embedded in the policy guidelines issued during the periods of acute CM shortage in the COVID-19 pandemic. These lessons were themed around CM conservation based on: type and priority of medical imaging investigation, kind of imaging modality and use of smaller vials over multi-dose vials packaging.
Implications for practice: The temporary crisis-driven strategies may offer critical lessons for post-pandemic service delivery to enhance patient safety while saving cost and promoting greener practice via strategic clinical and operational monitoring of CM through policy renewal, education and training and collaboration with industry partners.

Citation

Natembeya, M., Anudjo, M., Ackah, J., Osei, M., & Akudjedu, T. (2024). The environmental sustainability implications of contrast media supply chain disruptions during the COVID-19 pandemic: A document analysis of international practice guidelines. Radiography, 30(S1), 43-54. https://doi.org/10.1016/j.radi.2024.05.017

• Journal Article Type: Article
• Acceptance Date: May 30, 2024
• Online Publication Date: Jun 19, 2024
• Publication Date: 2024-06
• Deposit Date: Apr 14, 2025
• Journal: Radiography
• Print ISSN: 1078-8174
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 30
• Issue: S1
• Pages: 43-54
• DOI: https://doi.org/10.1016/j.radi.2024.05.017
• Keywords: Environmental sustainability; Contrast media; Green radiology; Climate change; Radiography; Document analysis
• Public URL: https://keele-repository.worktribe.com/output/1196152
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S1078817424001500?via%3Dihub
• Additional Information: This article is maintained by: Elsevier; Article Title: The environmental sustainability implications of contrast media supply chain disruptions during the COVID-19 pandemic: A document analysis of international practice guidelines; Journal Title: Radiography; CrossRef DOI link to publisher maintained version: https://doi.org/10.1016/j.radi.2024.05.017; Content Type: article; Copyright: © 2024 The Author(s). Published by Elsevier Ltd on behalf of The College of Radiographers.