Decarbonising Your Trial: Key Considerations

Clinical trial site selection can reduce carbon emissions by avoiding non-enrolling or underperforming sites that consume resources without delivering results. Efficient site selection minimises wasted setup activities, materials, and travel, accelerates recruitment, shortens trial duration, and reduces energy use and overall operational emissions.

• Data and AI support high-performing site selection by bringing together multiple data sources and applying analytics to predict future performance rather than relying on subjective judgement. Key inputs include enrolment rates, screen-fail ratios, protocol deviation history, data quality metrics, patient population access, and startup timelines.
• The physical location of sites directly affects emissions. Sites well connected by public transport or near major medical centres reduce travel-related emissions for participants, investigators, and monitors, while also improving accessibility and diversity.

Travel accounts for a substantial proportion of a trial’s environmental footprint. Reducing visits and shifting to low-carbon options provides a practical, scalable way to cut carbon emissions without compromising patient safety or trial outcomes.

• Effective trial design can reduce patient travel requirements through smarter planning. Examples include reducing in-person visit frequency and consolidating trial-related activities where possible.
• Leveraging decentralised and hybrid approaches, remote monitoring, virtual meetings and digital data capture can further reduce travel by sponsors, CROs, and site staff.
• Selecting investigator meeting locations based on attendee geographies can maximise low-carbon travel options.
• Embeding environmental principles into travel policies and incentivising low-carbon alternatives, for example public transport, rail over short-haul flights, car sharing, or electric vehicles can significantly lower carbon emissions
• Selecting accessible sites and monitoring staff local to site to reduce long-distance travel for patients and study teams.

Digital and remote trial solutions offer an opportunity to reduce the carbon emissions of clinical research while improving efficiency and patient experience.

• eConsent, wearable devices, remote data capture, and telemedicine reduce reliance on paper-based processes, physical infrastructure, and site-based activities, lowering emissions from printing, storage, and transportation.
• Remote technologies reduce in-person visits for patients, investigators, and monitors. Fewer visits can shorten timelines and reduce operational overheads.
• Assess the environmental impact of digital solutions themselves. Evaluating energy use from cloud infrastructure ensures technology delivers a genuine net carbon benefit — and that emissions are not merely shifted from one area to another.
• Digital solutions can increase site and patient burden as they work through new processes and technical challenges. A help desk approach can provide additional support in real-time reducing the time needed from site to resolve issues and improve the patient’s experience.
• Consult patients and regulators early to ensure data collected by digital solutions meets applicable quality standards and patient preferences.

Decentralised and hybrid models reduce emissions by allowing participants to take part from home or local facilities, significantly cutting the need for travel to central trial sites.

• Decentralised trials use digital tools, remote monitoring, and home-based assessments. Hybrid models combine remote elements with fewer, more targeted site visits, balancing flexibility with clinical oversight.
• Both approaches reduce the energy demand of large trial facilities such as lighting, heating, cooling, and extended on-site staffing as well as reduce the need for travel.
• Improved recruitment and retention: patients are less likely to withdraw when travel burdens are reduced, shortening timelines and avoiding emissions from delays, amendments, or additional site activation.

Clinical supply chains are often resource-intensive. Environmentally sustainable strategies across manufacturing, packaging, storage, and distribution can significantly lower emissions while improving operational efficiency and supply reliability.

• Adopt sustainable procurement practices such as ensuring vendors have sustainable credentials and carbon reduction plans, prioritise energy-efficient equipment, reusable components, and recycled or lower-impact materials.
• Optimise manufacturing and distribution: streamline production, minimise packaging, and use consolidated logistics to reduce waste and transport emissions.
• Reduce logistics emissions by using regional depots, lower-carbon transport modes, and temperature-controlled solutions with longer stability.
• Using accurate demand forecasting and adaptive trial designs can lower drug overage, a common source of avoidable waste and excess shipments.

regulatory compliance and patient safety.

• Replace single-use plastics with reusable or recyclable alternatives where standards allow such as reusable sample racks, metal instruments, or recyclable IMP packaging, validated against GCP, GMP and infection-control requirements.
• Reduce overage through improved forecasting using predictive tools, historical data, and scenario modelling. Adaptive resupply strategies and depot-level inventory visibility further limit unnecessary manufacturing and transport.
• Improve waste segregation at sites and depots to divert recyclable materials from costly, carbon-intensive clinical waste streams.
• Embed environmental procurement standards into vendor selection: prioritise suppliers with sustainability certifications, reduced packaging, and transparent environmental reporting.

Optimising site operations can significantly lower the environmental impact of clinical trials while improving efficiency and data quality.

• Transition to electronic Investigator Site Files (eISFs), electronic Case Report Forms (eCRFs), and digital monitoring notes to reduce paper consumption, printing, storage, and transport requirements.
• Encourage lower-carbon transport for patients and staff.
• Deploy energy-efficient equipment: low-energy freezers, LED lighting, and smart temperature control to reduce electricity consumption.

Waste reduction should be embedded at the earliest stages of study design. Protocol-level decisions have the greatest leverage on the volume of consumables, samples, and packaging generated throughout a trial.

• During protocol development, assess the environmental implications of planned procedures to limit unnecessary visits, tests, and materials.
• Promote recycling programmes at sites and depots with clear waste segregation guidance. Partner with facilities using renewable energy.
• Use predictive models to optimise lab kit, equipment, and IMP quantities, preventing oversupply and avoidable disposal at study end.
• Smart scanning and labelling minimise expiry loss via real-time visibility of expiry dates, automated First‑Expiry‑First‑Out (FEFO) inventory use, and early expiry alerts.
• Incorporate refurbished or remanufactured equipment where feasible, supported by validated cleaning and tracking processes.
• Take back programmes allow and encourage patients to return provisioned electronic devices for appropriate decontamination, recycling and reuse as appropriate.
• Donate surplus equipment or supplies meeting regulatory requirements to charities such as Kits for Life and International Health Partners.