Greener Inhaler Prescriptions in Primary Care (ID 277)
Barking, Havering and Redbridge Universities NHS Trust
Funding: None
Abstract
Aims / objectivesTo reduce repeat Fostair® MDI prescriptions at a GP surgery by 10%.
Methods
EMIS was searched for patients with repeat Fostair MDI prescriptions. Inclusion criteria:
∙ Age <65
∙ No spacer
∙ Asthma
This yielded 18 patients. Patients were offered to switch to a lower global warming potential (GWP) inhaler. Their inspiratory flow rate and current treatment efficacy were assessed, before being taught DPI technique.
Results
Of the 18 patients, 3 (16.6%) were uncontactable, 8 (44%) agreed to switch inhalers and 7 (38.9%) declined.
Additionally, 4 (27%) had insufficient control from their treatment regime and required stepping up. The total MDI prescriptions (excluding salbutamol) initially fell by 12.8%, remaining at 6.8% after 3 months.
Discussion
Asthma review provides an opportunity to assess inhaler technique as well as asthma control. 44% of patients were willing and keen to switch inhalers after being presented with the data. Many patients can achieve the same effect from DPIs as MDIs and pharmacologically equivalent inhalers are often available, enabling easy switching. The NHS accounts for 3% of the total emissions of the UK.¹ DPIs emit approximately 20-30 times less emissions than MDIs.² It is estimated that a shift from MDIs to DPIs would reduce total NHS carbon emissions by 4%.¹ Changing one patient from a MDI to DPI will save roughly 162,000g CO2 equivalent per annum.³ The switches achieved from this project will save 1,296,000g CO2 per annum.
References
[1] Hillman T, Mortimer F, Hopkinson NS. Inhaled drugs and global warming: time to shift to dry powder inhalers. BMJ 2013;346
[2] Janson C, Henderson R, Löfdahl M, et alCarbon footprint impact of the choice of inhalers for asthma and COPD, Thorax 2020;75:82-84.
[3] https://greeninhaler.org/the-problem-with-inhalers/
Oral presentation at the SHARE Conference 2021
Submitted to BTS Winter Meeting 2021 (Not accepted)
Conflicts of interest: None
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