Cross-sectional analysis of the carbon footprint of inhalers and its association with socioeconomic deprivation in Wales (ID 602)
Swansea Bay University Health Board
Abstract
Aim: To identify whether there is an association between prescribing of inhalers with a low global warming potential (GWP) and socioeconomic deprivation in Wales.
Background: Inhalers are responsible for around 3-4% of the total NHS carbon footprint. The majority of which can be attributed to meter dose inhalers (MDI) due to their hydrofluorocarbon propellants, resulting in their classification as inhalers with a high GWP. Dry powder inhalers (DPIs) and soft mist inhalers (SMIs) do not contain propellants so have a low GWP. In 2021, NHS Wales set out a Decarbonisation Strategic Delivery Plan to increase prescribing of inhalers with a low GWP to 80% by 2025. This study aims to assess whether socioeconomic deprivation presents a potential barrier to achieving this, given the significant variation in prescribing rates of low GWP inhalers across Wales.
Methods: A cross-sectional analysis was conducted of practice deprivation quintile scores, utilising Welsh Index of Multiple Deprivation (WIMD) data and DPI and SMI prescribing data, provided by All Wales Therapeutics and Toxicology Centre for 372 GP practice across Wales.
Results: Our analysis found no discernible relationship between DPI and SMI prescribing rates and socioeconomic distribution (R² = 0.0081, p = 0.08; F = 0.083). However, we cannot rule out the possibility of complex non-linear associations, which may arise due to subtle variations in prescribing patterns, including differences in patient age, comorbidities, regional clinical practices, or healthcare access.
Conclusion: Evidence is currently insufficient to confirm an association between prescribing of inhalers with a low GWP and socioeconomic deprivation in Wales. The use of a pooled WIMD data possibly incorporates significant confounding variables, which could potentially mask true associations between prescribing rates and disaggregated deprivation matrix. Substantial unexplained variation in prescribing supports the need for further investigation and inhaler decarbonisation initiatives.
Funding: None
Conflicts of interest: None
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