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519 Green inhaler audit

Archives of disease in childhood, 2023-07, Vol.108 (Suppl 2), p.A212-A213 [Peer Reviewed Journal]

2023 Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ. ;ISSN: 0003-9888 ;EISSN: 1468-2044 ;DOI: 10.1136/archdischild-2023-rcpch.337

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  • Title:
    519 Green inhaler audit
  • Author: Willson, Alice ; West, Rebecca ; Turnbull, Louise
  • Subjects: Asthma ; Audit objectives ; Carbon dioxide ; Carbon footprint ; Children ; Data collection ; Economic Impact ; Inhalers ; Patients ; Pediatrics
  • Is Part Of: Archives of disease in childhood, 2023-07, Vol.108 (Suppl 2), p.A212-A213
  • Description: ObjectivesMetered dose inhalers (MDI’s) are known to have a high carbon footprint.1 There is a national2,3 and local4,5 drive to reduce the use of MDI’s in favour of dry-powder inhalers (DPI’s) which are better for the planet. Within our cohort of children with severe asthma we wanted to understand what the difference in carbon footprint could be if our patients were switched from MDI’s to DPI’s. We also wanted to establish the economic impact.MethodWe reviewed all children aged 5–12 years in our database of children in the Severe Asthma Clinic at a tertiary children’s hospital. We excluded all the children who had been discharged from our service. We reviewed electronic clinic letters to ascertain the child’s preventer and reliever medication. Where possible we also reviewed the GP local care record to specify the brand of preventer medication prescribed, and quantity of inhalers prescribed in the last year.The annual use of inhalers are ranked by Carbon Dioxide equivalent (CO2e) impact according to www.gov.uk/ expressed as mileage in an average car e.g. 25 miles for one years daily use of long term inhalers. (1) We used Excel for data collection and simple calculations of CO2e and cost.ResultsLooking at 49 patients we found that all patients could switch to a ‘greener’ alternative.The current carbon footprint of our cohort is 59,282.5 miles per year. This costs £16,963.32 per year.The alternative carbon footprint is 4,976.50 miles per year. This would cost £22,771.32 per year ( an additional £5808). This constitutes a 91% reduction in carbon footprint for a 30% cost increase.Within MDI’s, if all Ventolin inhalers were switched to Salamol CFC free inhalers (saving 4p per inhaler) there would be a carbon footprint reduction of 3819 miles per year.ConclusionThis assessment demonstrates that a dramatic reduction in carbon footprint could be achieved by changing children over to DPI’s. This comes at a higher cost in the short term, however, even simple measure such as changing from Ventolin to Salmol CFC free MDI’s, or just changing reliever (not preveneter) medication to DPI’s could make a big difference. There are many other ways of reducing inhaler use – not least improving overall asthma control – but our audit suggests a practical approach for optimising prescribing choices in our cohort.ReferencesInhaler carbon footprint data, PrescQuipp, 2022. https://www.prescqipp.info/our-resources/bulletins/bulletin-295-inhaler-carbon-footprint/NHS Long Term Plan, NHS England, 2019. www.longtermplan.nhs.uk/Delivering a ‘Net Zero’ National Health Service, NHS England, 2020. www.england.nhs.uk/greenernhs/GM Greener NHS Programme – Update Report, Greater Manchester joint Commissioning Board, 2021. https://democracy.greatermanchester-ca.gov.uk/documents/s15631/JCB%20-%20Net%20Zero%20Update%20V1.1.pdfFive-Year Environment Plan for Greater Manchester, GMCA, 2019. www.greatermanchester-ca.gov.uk/
  • Publisher: London: BMJ Publishing Group LTD
  • Language: English
  • Identifier: ISSN: 0003-9888
    EISSN: 1468-2044
    DOI: 10.1136/archdischild-2023-rcpch.337
  • Source: AUTh Library subscriptions: ProQuest Central
    Alma/SFX Local Collection
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