F-GASES UTILISED AS MEDICAL AEROSOLS ACCOUNT FOR LESS THAN 0.1% OF GLOBAL GREENHOUSE EMISSIONS1–3
Inhalers contribute a relatively small proportion of global greenhouse gases and we believe, rather than inhaler usage, other areas within the NHS, which have little or no negative impact on patient care, could be prioritised.4 Instead, we are looking to invest in future respiratory innovations to help protect the environment.5,6
NO ONE DEVICE SUITS ALL PATIENTS
There are many considerations when deciding on the right inhaler device for a patient. Some patients are unable to generate the required level of inspiratory flow to activate a DPI, and some lack the required coordination to effectively use a pMDI.7 They may face difficulties relating to other comorbidities or their age.7
An appropriate inhaler device can help improve outcomes, adherence and quality of life, while an unsuitable one may lead to critical errors in inhaler technique and poor disease control.1,7–9 This in turn has a negative effect on the environment, including increased use of healthcare resources, hospitals and clinics, and waste of inhalers due to incorrect use.9,10
Enforcing stable respiratory patients to switch inhaler devices can also lead to detrimental effects on quality of care and patient outcomes1 and could risk setting back years of multi-stakeholder efforts to implement sustainable respiratory healthcare services and reduce overall NHS carbon emissions.
KEEP PATIENT HEALTH AT THE CENTRE OF DECISION-MAKING TO PROTECT PATIENTS AND THE PLANET
It is important that both pMDIs and DPIs remain an option for patients depending on their needs. The choice of inhaler device should be the result of an informed discussion between you and your patient.11
Whether that’s a pMDI or a DPI, we want to support you in your choice.
- Panigone S et al. An environmentally sustainable patient-centred solution for asthma and COPD. Pulmonary & Nasal Drug Delivery. On Drug Delivery. 2020; 106: 14–19.
- The Intergovernmental Panel on Climate Change. AR5 Climate Change 2014: Mitigation of Climate Change. Available at: https://www.ipcc.ch/site/assets/uploads/2018/02/ipcc_wg3_ar5_full.pdf. Accessed May 2021.
- OzonAction Kigali Fact Sheet 2 OzonAction Current Use of HCFCs and HFCs. Available at: http://wedocs.unep.org/bitstream/handle/20.500.11822/26867/7877FS02_C_Uses_EN.pdf?sequence=1&isAllowed=y. Accessed May 2021.
- House of Commons Environmental Audit Committee. UK Progress on Reducing F-gas Emissions. 18 April 2018. Available at: https://publications.parliament.uk/pa/cm201719/cmselect/cmenvaud/469/469.pdf. Accessed May 2021.
- NHS Long Term Plan. January 2019. Available at: https://www.longtermplan.nhs.uk/wp-content/uploads/2019/08/nhs-long-term-plan-version-1.2.pdf. Accessed May 2021.
- The way we act. Chiesi Sustainability Report 2019. Available at: https://www.chiesi.uk.com/pdf/Chiesi_Sustainability_Report_2019_ENG.pdf. Accessed May 2021.
- Usmani OS. Choosing the right inhaler for your asthma or COPD patient. Ther Clin Risk Manag. 2019; 15: 461–472.
- Price D et al. Inhaler errors in the CRITIKAL study: Type, Frequency, and Association with Asthma Outcomes. J Allergy Clin Immunol Pract. 2017; 5(4):1071–1081.
- Melani AS et al. Inhaler mishandling remains common in real life and is associated with reduced disease control. Respir Med. 2011; 105(6):930–938.
- Usmani OS, Scullion J, Keeley D. Our planet or our patients-is the sky the limit for inhaler choice? Lancet Respir Med. 2019; 7(1): 11–13.
- Kaplan A, Price D. Matching inhaler devices with patients: the role of the primary care physician. Can Respir J. 2018; 9473051.