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The following is a summary of “Discarded intravenous medication in the ICU: the GAME-OVER multicenter prospective observational study,” published in the February 2025 issue of Critical Care by d’Aranda et al.
Researchers conducted a retrospective study to examine medication waste in the intensive care unit (ICU), highlighting its impact on healthcare sustainability and ecosystems.
They carried out the GAME-OVER French study (November 2022–March 2023) over a 24-hour period chosen by each center. Adult ICUs participated voluntarily, and individuals in hospital who did not object were included. The primary endpoint measured the percentage of discarded intravenous medication (DIVM) in the ICU, calculated as the ratio of discarded volume to total prepared volume. Secondary endpoints identified risk factors, main causes of medication waste, and estimated associated healthcare costs.
The results showed that among 81 ICUs and 1,076 enrolled individuals, 408.9 L of 130 intravenous (IV) medications were prepared. The discarded volume totalled 43.8 L, accounting for 10.7% of IV medication waste (95% (CI), 9.9–11.5). Factors independently linked to increased waste included the number of daily admissions and discharges, elective surgery admissions, Sequential Organ Failure Assessment (SOFA) score ≥7, endotracheal intubation, renal replacement therapy (RRT), and body mass index and 90%of pharmaceutical waste came from 25 key drugs, with an estimated national annual cost of 2,737,163€.
Investigators concluded that substantial ICU IV medication waste, driven by largely unchangeable risk factors, necessitated sustainable patient care and resource management practices.
Source: ccforum.biomedcentral.com/articles/10.1186/s13054-025-05299-6
