Introduction

Climate change is an important driver of health inequalities. Air pollution disproportionately affects deprived and vulnerable communities [1]. Inhaled therapies are key components of respiratory conditions such as asthma and chronic obstructive pulmonary disease (COPD). Hydrofluorocarbons (HFCs) found in meter dose inhalers (MDIs) are powerful greenhouse gases. MDIs have a high carbon footprint of 500g CO2eq per dose, compared to 20g in Dry powder inhalers (DPIs) [2]. The MDI prescribing carbon footprint is equivalent to 850,000 tonnes of carbon emissions each year in England [2]

Aim

Identify most common inhaler prescribing methods and develop an action plan to support a reduction in MDI prescriptions within our Trust

Methods

A retrospective audit of inhaler prescribing with all respiratory outpatient contacts in a 1-month period from 1 February to 28 February 2022

Results

Most prescriptions were MDIs (n=137, 61%) compared to DPIs (n=89, 39%)

Conclusions

Most DPIs were prescribed for COPD management which highlights good practice and adoption of environmental concerns. Most MDIs were prescribed in asthma treatment as well as COPD reliever choice. This suggests possible clinician concerns about the presumed efficacy of DPIs in treating the asthma population and copd exacerbation. Further research and clinician education is advised to align clinical and environmental concerns in this area

1. Public Health England, "Health Matters: Air Pollution," UK Government, London, 2018

2.Pharmaceutical Services Negotiating Committee, "Reducing the climate change impact of inhalers: environmentally safe disposal," London, 2021