Observational studyCritical care (London, England)2025
Discarded intravenous medication in the ICU: the GAME-OVER multicenter prospective observational study.
Observational study in Critical care (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT05553054 (Drug Wastage), which is not on this map. Cited by 5 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Drug Wastage : Observational Study in Intensive Care Units in France
Who cites it
5 citing papers in PubMed.
- Correction: Discarded intravenous medication in the ICU: the GAME-OVER multicenter prospective observational study.Critical care (London, England) · 2026Article
- Climate resilience as a strategic lever for long-term healthcare sustainability: a narrative review.British journal of anaesthesia · 2026Review
- Sustainable Intensive Care: Do Not Forget IV to Oral Switch!Critical care medicine · 2026Article
- Characteristics of French intensive care units and patients: an ancillary analysis of the GAME-OVER study.BMC anesthesiology · 2025Observational
- Canadian Anesthesiologists' Society position statement on greening the operating room.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2025Article
Corrections and comments
- Erratum issued
Authors and funding
24 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMedication waste is a contributor to the healthcare environmental footprint and impacts ecosystems. Data on medication waste in the intensive care unit (ICU) are scarce, and therefore are essential to develop new sustainable strategies.
methodsThe GAME-OVER French multicenter prospective observational study was conducted from November 2022 to March 2023, over a 24-h period of choice, at the discretion of each participating center. Adult ICUs were enrolled in the study on a voluntary basis and hospitalized patients who did not express opposition were included in the analysis. The primary endpoint was the percentage of discarded intravenous (IV) medication in the ICU, defined as the ratio of the discarded volume to the total volume of IV medication prepared. Secondary endpoints included identifying risk factors and main reasons for medication waste and estimating its related healthcare cost.
resultsAmong the 81 ICUs and the 1076 enrolled patients, 408.9 L of 130 IV medications were prepared. The discarded volume was 43.8 L, resulting in a 10.7% discarded IV medication (95% Confidence Interval (CI), 9.9-11.5). Number of daily admissions/discharges in the ICU, as admission for elective surgery, Sequential Organ Failure Assessment score ≥ 7, endotracheal intubation, renal replacement therapy and body mass index were independently associated with increased discarded IV medication. Ninety percent of pharmaceutical waste was attributed to 25 key drugs, with an estimated national annual cost of 2,737,163€.
conclusionsDiscarded intravenous medication in the ICU is considerable and results in significant costs for the health care system, without obvious patient-centered value. Risk factors associated with medication waste were largely nonmodifiable, emphasizing the need for sustainable practices in patient care and resource management.
trial registrationClinicalTrials.gov: NCT05553054 . September 23, 2022.
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