Guideline on climate conscious prescription of inhaled medication

Guido Schmiemann, Doerks Michael

Keywords: climat change, inhaler,

Introduction:

In Germany, the health care system is responsible for about 5 % of CO2 emissions.
The biggest share in the carbon footprint caused by Primary Care is the prescription of medicines, followed by emissions from mobility (patients and staff) and heating.
For the therapy of asthma/ chronic obstructive pulmonary disease different types of inhalers are used. The extent to which these inhalers contribute to climate changes varies depending on their mode of action. Essentially inhaled medicines can be divided into metered-dose inhalers (DA) and powder inhalers (DPI).
Due to their propellants DA have a high damage potential for the atmosphere (global warming potential - GWP). For example in the UK metered dose inhalers are responsible for 3.5 % of the greenhouse gas emissions of the entire UK health system.
Switching to more climate-friendly DPIs can led to a substantial reduction in greenhouse gas emissions without adverse effects on asthma control. Aim of the project is to provide support for a change in the prescribing pattern of inhaled medicines and thereby to reduce the CO2 footprint of the health care system by formulating a practice based guideline.

Method:

Expert panel and systematic search of guideline recommendations

Results:

In 2022 the guideline was issued by the German College of General Practitioners and Family Physicians. An english version was issued to increase visibility. As a next step an update as an interdisciplinary guideline together with further specialists (paediatrics, pulmonology, pharmacy) is under way.

Conclusions:

Addressing the impact of medication on global carbon footprint can be an example to discuss the environmental impact in daily practice

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