Evidence map›Paper›PMID 40949074›Full record

ArticleCureus2025

Optimising Paracetamol Prescribing for Safer, Greener, and Cost-Effective Care: Lessons From an Ongoing Emergency Department Quality Improvement Project.

Vijay Lakshmanan, Michael Rosser

Abstract read
In one paragraph

Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

Vijay LakshmananHospital Medicine, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, GBR.
Michael RosserEmergency Medicine, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, GBR.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Paracetamol is one of the most frequently prescribed analgesics in emergency departments (EDs). While intravenous (IV) and oral formulations provide similar analgesic effects, IV paracetamol is more expensive and has a carbon footprint several-fold higher than oral administration. In patients who can take oral medication, the oral route is safer, greener, and more cost-effective. At Royal Preston Hospital in Preston, UK, the baseline audit data from December 2022 to November 2023 revealed that IV paracetamol accounted for approximately 38% of all 1 g paracetamol doses prescribed in the ED. Following informal teaching sessions and staff engagement, a re-audit from February to April 2024 demonstrated no significant reduction in IV use. A further audit from May 2024 to March 2025 revealed no significant reduction in IV paracetamol use, with prescribing rates continuing to hover around 35% to 40% across most months. These findings highlight that early educational interventions can influence prescribing behavior but may be insufficient to deliver lasting change. To build on this work, a structured quality improvement (QI) approach was adopted to implement more targeted and sustainable interventions, including formal teaching, visual prompts, and regular feedback cycles. By encouraging appropriate use of oral paracetamol, this project aims to reduce unnecessary IV prescribing while improving patient safety, lowering costs, and contributing to environmentally sustainable practice. Importantly, this remains an ongoing, multi-cycle initiative, with a third round of data collection commencing in August 2025. This QI report aims not only to outline the effectiveness and sustainability impact of optimizing paracetamol prescribing but also to demonstrate how similar projects can be replicated across various other healthcare departments worldwide. Such initiatives have the potential to promote safer, greener, and more cost-effective care with global relevance.

Indexed as

emergency departmentsenvironmental sustainabilityhealthcare sustainabilityhospital sustainabilityintravenous paracetamollow-cost healthcareparacetamolquality improvement projectsimple quality improvement projectsustainability in healthcare

Identifiers

PMID40949074
PMCPMC12426579

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.