Climate medicine: How does extreme heat affect medication?

The Institute Institute for General Medicine at the University of Cologne receives a million euro grant from the Federal Innovation Fund for its research project 'ADAPT-HEAT – heat sensitive medication adaption'.

One of the aims of the project is to create the so-called CALOR list. It is intended to help doctors in practices and hospitals to adjust medication during heatwaves and to recognise and counteract risks at an early stage.

Heatwaves are becoming more frequent in parts of the world previously unaffected. As climate change progresses, this trend is expected to continue. Extreme heat poses a serious risk to health, sometimes with fatal consequences: According to the Robert Koch Institute, there were around 20,000 heat-related deaths in Germany between 2018 and 2020.

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Focus on environmental medicine

Harmful substances in the soil, water and air also endanger people's health. In recent years, environmental medicine has been increasingly concerned with the consequences of climate change.

Extreme temperatures can also become a risk factor for medication. People with several illnesses (multimorbidity), for example, are affected as a given drug's mode of action can change in the heat. Insufficient fluid intake (dehydration) can also have a negative impact on the effect of medication. There are also drugs whose pharmacological properties can change at high temperatures.

Climate medicine deals with these and other risks of climate change for health. The Institute of General Medicine at Cologne University Hospital is playing a pioneering role in this field with its focus on climate change and sustainability in GP care. Prof. Dr Beate Müller: "The health effects of climate change, such as allergies and heat-related health problems, are already on the rise. The first place that affected patients often go to is their GP practice, which is why good concepts are needed to meet these new challenges. With the CALOR list, we want to develop practice-relevant recommendations that are useful in GP practices and beyond."

Together with the primary medical care research group (PMV) at Cologne University Hospital, the Institute of General Medicine at Hanover Medical School and other partner institutions (e.g. Cologne City Health Department), the ADAPT-HEAT project is using a multi-stage process to develop a list of medications whose effects can change when exposed to heat. This so-called CALOR list (calor Latin for heat) is primarily intended to help doctors in private practice to adjust medication during heat episodes and to recognise and counteract risks at an early stage. Ultimately, the aim is to improve patient safety in drug therapy.

The researchers are investigating the relevance of the influence of certain medications on health during heatwaves using statutory health insurance billing data linked to heat data from the German Weather Service (Deutscher Wetterdienst; DWD). The aim is to identify links between heatwaves and the adverse effects of medication. "By working with Prof Dr Andreas Matzarakis and using data from the DWD, we hope to be able to map the heat stress for people in Cologne very accurately. We can then relate this to the medication that these people have been prescribed," explains Ingo Meyer, head of the PMV research group.

The project started in January 2024 with a total duration of three years. It is funded by the Innovation Fund of the Joint Federal Committee (funding reference 01VSF23016). The project aims to provide both healthcare professionals and patients with a good overview of heat-sensitive medication with clear recommendations for adjustments in order to avoid heat-related health problems.

Source: University Hospital Cologne

08.02.2024