Abstract:Study Protocol of Eco-Directed Sustainable Prescribing in Malaysia: Knowledge, Awareness and Attitudes among Medical Students Gursimran Kaur1,2, Maria Lee HS1,2, Cindy Lee Ik Sing1,2, Steffi Tan Shih May1,2 Background Polypharmacy, the use of five or more medications, is prevalent among older adults which poses significant risks, including poor adherence, adverse drug events and unnecessary medication use. Consequently, amplifying environmental harm through inappropriate medication disposal. These challenges highlight an urgent need to explore a globally advancing prescribing paradigm, the eco-directed sustainable prescribing (EDSP). EDSP integrates safe prescribing practices with planetary health principles. While pharmaceutical disposal behaviour has been studied, no direct studies have yet examined awareness, attitudes, or implementation of EDSP in Malaysia. This pioneer and multipronged study will focus on medical students and aim to bridge clinical safety, patient empowerment, and planetary health. Objectives Assess understanding of medication prescribing and the impact on environment among medical students Assess awareness and understanding of EDSP among medical students Assess attitudes toward the environmental impacts of medication prescribing and disposal practices Methods A cross-sectional study will be conducted among 100 medical students (recruited with purposive sampling) enrolled at Malaysian medical universities. A structured self-administered questionnaire will be used, comprising of Likert-scale items alongside open-ended questions. Quantitative data will be analysed using descriptive and inferential statistics, while open-ended responses will undergo thematic analysis to provide additional context and insights. Ethical approval: Ethical approval not obtained. Significance This initial phase will explore the intersection of EDSP practices and prescribing practices among medical students, with future phases possibly examining patient-level and healthcare professionals dynamics to generate evidence-based frameworks. Integrating eco-conscious prescribing within medical education and healthcare aligns with Malaysia’s Universal Health Coverage goals and contribute to global healthy ageing and sustainability agendas. Study Status: Planned but not yet initiated.
Keywords: Health Systems and Universal Health Coverage (UHC), Polypharmacy, Adherence, Environment, Primary Care Interventions
