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Drug UseGAME-OVERNCT05553054

Drug Wastage : Observational Study in Intensive Care Units in France

An observational study of Drug Use, run by Centre Hospitalier Intercommunal de Toulon La Seyne sur Mer at 61 sites in 3 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Environmental awareness leads medical field to question its responsibility and possibilities for action. Drug residues can have a major environmental impact as per their bioaccumulation, toxicity and persistence characteristics, depending on where they are discarded. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Drug Use
What is being tested?
Quantification of IV drugs wastage
Type of treatment
Injection or infusion
How many people
1,066 participants
Where
61 sitesin 3 countries
Study dates
8 Nov 2022to 15 Mar 2023
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: Adult patients hospitalized in intensive care units during the 24 hours of data collection.

Who may be able to join

  • Adult patients hospitalized in intensive care units during the 24 hours of data collection.

Who cannot join

  • Patient's opposition to participate in the study or patient family opposition if the patient is not able to be informed.

Trial locations and contacts

61 sites in 3 countries.

61 sites in 3 countries

France59 sites

  • CHU d'Amiens

    Amiens, Somme, 80054

  • CHU d'Angers

    Angers, Maine-et-Loire, 49100

  • Hôpital privé d'Antony

    Antony, Hauts-de-Seine, 92160

  • Centre Hospitalier Victor Dupouy

    Argenteuil, Val d'Oise, 95100

  • Centre Hospitalier d'Aurillac

    Aurillac, Cantal, 15000

  • CHU de Besançon

    Besançon, Doubs, 25000

  • Centre Hospitalier Simone Veil

    Blois, Loir-et-Cher, 41000

  • Clinique Saint Augustin

    Bordeaux, Gironde, 33000

  • CHU de Bordeaux - Hôpital Pellegrin

    Bordeaux, Gironde, 33076

  • HIA Robert Picqué

    Bordeaux, Gironde, 33140

  • HIA Clermont Tonnerre

    Brest, Finistère, 29240

  • CHRU de Brest

    Brest, Finistère, 29609

  • Hôpital Pierre Wertheimer

    Bron, Rhône, 69677

  • Centre Hospitalier de Cahors

    Cahors, Lot, 46005

  • CHRU de Tours

    Chambray-lès-Tours, Indre-et-Loire, 37170

  • Centre Hospitalier de Charleville-Mezieres

    Charleville-Mézières, Ardennes, 08000

  • HIA Percy-Clamart

    Clamart, Hauts-de-Seine, 92141

  • CHU de Clermont-Ferrand

    Clermont-Ferrand, Puy-de-Dôme, 63003

  • Hôpital Henri Mondor

    Créteil, Val-de-Marne, 94000

  • Centre Hospitalier de Dax

    Dax, Landes, 40100

  • Groupe Hospitalier Littoral Atlantique

    La Rochelle, Charente-Maritime, 17019

  • CHU de Grenoble

    La Tronche, Isère, 38700

  • Centre Hospitalier de Versailles

    Le Chesnay, Yvelines, 78150

  • Centre Hospitalier Emile Roux

    Le Puy-en-Velay, Haute-Loire, 43000

  • Hôpital Robert Boulin

    Libourne, Gironde, 33500

  • CHU de Lille - Hôpital Huriez

    Lille, Nord, 59037

  • CHU de Lille - Hôpital Roger Salengro

    Lille, Nord, 59037

  • CHU Dupuytren

    Limoges, 87042

  • Hôpital Edouard Herriot

    Lyon, Rhône, 69003

  • Clinique de la Sauvegarde

    Lyon, Rhône, 69009

  • Hôpital Nord

    Marseille, Bouches Du Rhône, 13015

  • Grand Hôpital de l'Est Francilien

    Meaux, Seine-et-Marne, 77100

  • Centre Hospitalier de Mont-de-Marsan

    Mont-de-Marsan, Landes, 40024

  • Centre Hospitalier du Forez

    Montbrison, Pays de la Loire Region, 42600

  • Centre Hospitalier de Montélimar

    Montélimar, Drôme, 26216

  • Hôpital Américain de Paris

    Neuilly-sur-Seine, Hauts-de-Seine, 92200

  • CHU de Nîmes

    Nîmes, Gard, 30900

  • Centre Hospitalier d'Orléans

    Orléans, Loiret, 45100

  • Hôpital Lariboisière

    Paris, 75010

  • Hôpital La Pitié-Salpétrière

    Paris, 75013

  • Hôpital Bichat

    Paris, 75018

  • CHU de Poitiers

    Poitiers, Vienne, 86021

  • Hôpital privé Claude Galien

    Quincy-sous-Sénart, Essonne, 91480

  • Clinique la Croix du Sud

    Quint-Fonsegrives, Haute-Garonne, 31130

  • CHU de Reims

    Reims, Marne, 51100

  • CHU de Rennes

    Rennes, Ille-et-Vilaine, 35033

  • CHU Félix-Guyon

    Saint-Denis, Réunion, 97400

  • Centre Hospitalier Mémorial de Saint-Lô

    Saint-Lô, Manche, 50000

  • Centre Hospitalier de Saint Nazaire

    Saint-Nazaire, Loire-Atlantique, 44600

  • CHU de la Réunion

    Saint-Pierre, Réunion, 97410

  • CHU de Saint-Etienne

    Saint-Priest-en-Jarez, Pays de la Loire Region, 42270

  • CHRU de Strasbourg

    Strasbourg, Bas-Rhin, 67098

  • HIA Sainte Anne

    Toulon, Var, 83000

  • Hôpital Sainte Musse

    Toulon, Var, 83056

  • CHU de Toulouse - Hôpital Purpan

    Toulouse, Haute Garonne, 31059

  • CHU de Toulouse - Hôpital Rangueil

    Toulouse, Haute-Garonne, 31059

  • Clinique Pasteur

    Toulouse, Haute-Garonne, 31300

  • Hôpital Nord Franche-Comté

    Trévenans, Territoire De Belfort, 90400

  • Centre Hospitalier Bretagne Atlantique de Vannes

    Vannes, Morbihan, 56017

Other trials in France

Mayotte1 site

  • Centre Hospitalier de Mayotte

    Mamoudzou, 97600

Monaco1 site

  • Centre Hospitalier Princesse Grace

    Monaco, 98000

Other trials in Monaco

About this study

Environmental awareness leads medical field to question its responsibility and possibilities for action.

Drug residues can have a major environmental impact as per their bioaccumulation, toxicity and persistence characteristics, depending on where they are discarded. In France, drug residues should be disposed of by incineration, but in practice, this is not systematic. Moreover, data on drug wastage in Intensive Care Units (ICU) are rare.

GAME-OVER observational study aims to evaluate drug wastage in ICU in France and to suggest ways to improve health care practices.

Read the detailed description

Observational study with data collection during a 24-hour business day. Data collected refer to healthcare team's practices and patients.

Collection starts when day shift starts (at 7:00 am) and ends when night shift leaves (at 7:00 am the following day).

Conditions
Drug Use
Being tested
Quantification of IV drugs wastage
Keywords
Intravenous (IV) drug, Waste, Intensive Care Unit (ICU), Environmental sustainability, Drug wastage, Care Eco-design

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Quantification of IV drugs wastageOther

    Drugs are prescribed depending on physician discretion.

    Specific collection bins are provided to ICU. Healthcare teams discard syringes labelled with name and dilution which have been used to prepare drugs into these bins. After 24 hours of collection, bins are analyzed by investigators.

Study groups in NCT05553054
Study groupRoleWhat they receive
Intravenous (IV) drugsPatient and prepared/administrated/discarded IV drugs data will be collected during 24 hours.
Receives: Other: Quantification of IV drugs wastage

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Ratio of overall wastage in milliliter (mL) of prepared and discarded IV drugs to overall volume in milliliter (mL) of prepared IV drugs.

    Wastage is defined as any prepared and unused drug that remains in syringe or IV bag.

    Measured: 24 hours

Secondary outcomes (4)

  1. Reason for discarding drug residues

    A questionnaire will be fulfilled by healthcare teams with the following possible categories:

    1/ prepared in advance and not used ; 2/ systematic change at fixed times ; 3/ prescription change ; 4/ change by anticipation of care ; 5/ drug no longer needed ; 6/ preparation error ; 7/ other reason.

    Measured: 24 hours

  2. Drug residues discarding process

    A questionnaire will be used to determine which discarding process are applied by nurses in their usual pratices.

    Measured: 24 hours

  3. Use of enteral administration route

    Use of enteral administration route versus per os and IV routes will be analyzed for paracetamol and proton pump inhibitor according to the accessibility of enteral route and the reason and the date of patient entry in ICU.

    Measured: 24 hours

  4. Cost of overall IV drug wastage

    Estimated cost of drug residues will be evaluated for each drug, according to the reason for discarding, by the following formula :

    volume of discarded IV drugs x theoretical price

    Measured: 24 hours

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted23 Sep 2022
  2. Study start8 Nov 2022
  3. Primary completion15 Mar 2023
  4. Study completion15 Mar 2023

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
1,066 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05553054
Sponsor's protocol ID
2022-CHITS-009
Acronym
GAME-OVER
Status last verified
Jul 2026
First submitted
21 Sep 2022
Last updated
7 Jul 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Atchade E, Cungi PJ, Pons S, Dahyot-Fizelier C, Cesana M, Lukaszewicz AC, Bouhemad B, Trouiller P, Chelly J, Montravers P, Vardon F, D'Aranda E; SFAR Critical Care Committee; SFAR Sustainability Committee; SFAR Research Network; GAME-OVER Study group; GAME-OVER investigators group. Characteristics of French intensive care units and patients: an ancillary analysis of the GAME-OVER study. BMC Anesthesiol. 2025 Dec 5;26(1):27. doi: 10.1186/s12871-025-03473-5.

    PubMed 41345913

  • d'Aranda E, Cungi PJ, Chelly J, Pons S; GAME-OVER Study Group, GAME-OVER Study Investigators, French Society of Anesthesia & Intensive Care Medicine (SFAR) Sustainability; Committee, SFAR Critical Care Committee, and SFAR Research Network; GAME-OVER Study Group, GAME-OVER Study Investigators, French Society of Anesthesia & Intensive Care Medicine (SFAR) Sustainability and Committee, SFAR Critical Care Committee, and SFAR Research Network. Sustainable Intensive Care: Do Not Forget IV to Oral Switch! Crit Care Med. 2026 Jan 1;54(1):218-223. doi: 10.1097/CCM.0000000000006944. Epub 2026 Jan 6. No abstract available.

    PubMed 41493367

  • d'Aranda E; GAME-OVER investigators group; Pons S, Chelly J, Atchade E, Bonnet L; SFAR Sustainable Development Committee; Dahyot-Fizelier C; SFAR Critical Care Committee; Kamel T, Giannoni F, Collange O, Besnier E, Schoeffler M, Mayeur N, Quere PL, Marecal L, Pernod C, Geay C, Esnault P, Cinotti R; SFAR Research Network; Cesana M, Cungi PJ. Correction: Discarded intravenous medication in the ICU: the GAME-OVER multicenter prospective observational study. Crit Care. 2026 Jan 21;30(1):32. doi: 10.1186/s13054-025-05822-9. No abstract available.

    PubMed 41566365

  • d'Aranda E; GAME-OVER study group; GAME-OVER investigators group; Cungi PJ, Le Marec T, Giannoni F, Marecal L, Mayeur N, Mitri F, Cesana M; SFAR Sustainable Development Committee; SFAR Critical Care Committee, the SFAR Research Network; Chelly J, Pons S. Management of liquid pharmaceutical residues in the intensive care unit: an ancillary analysis of the multicenter observational GAME-OVER study. Intensive Crit Care Nurs. 2026 Aug 27;98:104479. doi: 10.1016/j.iccn.2026.104479. Online ahead of print.

    PubMed 42660042

  • d'Aranda E; GAME-OVER investigators group; Pons S, Chelly J, Atchade E, Bonnet L; SFAR Sustainable Development Committee; Dahyot-Fizelier C; SFAR Critical Care Committee; Kamel T, Giannoni F, Collange O, Besnier E, Schoeffler M, Mayeur N, Quere PL, Marecal L, Pernod C, Geay C, Esnault P, Cinotti R; SFAR Research Network; Cesana M, Cungi PJ. Discarded intravenous medication in the ICU: the GAME-OVER multicenter prospective observational study. Crit Care. 2025 Feb 21;29(1):84. doi: 10.1186/s13054-025-05299-6.

    PubMed 39985053

Questions about this trial

What is this clinical trial studying?

An observational study of Drug Use, run by Centre Hospitalier Intercommunal de Toulon La Seyne sur Mer at 61 sites in 3 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 7 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 61 sites in France, Mayotte, Monaco. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Ratio of overall wastage in milliliter (mL) of prepared and discarded IV drugs to overall volume in milliliter (mL) of prepared IV drugs. (time frame: 24 hours). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05553054, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 7 Jul 2026.

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