A green initiative involving Gloucestershire GP practices is encouraging people with asthma to swap inhalers to help the environment.

30 GP practices in the county have now signed up for the initiative led by the National Service for Health Improvement (NSHI).

Practices were invited to participate in the project that offers an alternative to prescribing metered-dose (MDI) inhalers – which use gases that affect the environment.

Dry Powder Inhalers (DPI) are better for the environment because they do not use powerful greenhouse gas propellants like MDI inhalers.

While MDIs use gases that contribute to climate change, DPIs deliver medication when the patient breathes in and are not used in conjunction with spacer devices (plastic tubes that fit onto the mouthpiece of an inhaler to help the user breathe medicine into their lungs more easily).

Because the need for propellants is eliminated, it results in a much lower carbon footprint.

Under this project, 448 patients have already been swapped from MDI to DPI inhalers and NHS Gloucestershire ICB has one of the lowest average carbon footprints per inhaler in the NHS.

Data from the Medicines Optimisation Team at NHS Gloucestershire shows that one MDI to DPI inhaler swap saves 10,764 grams of CO₂ which is roughly equivalent to half the annual carbon absorption of one mature tree (0.49), driving about 27 miles in a typical petrol car and avoiding the emissions from charging a smartphone over 1,300 times.

Mark Gregory, Senior Pharmacist at NHS Gloucestershire said:

“Initially we invited GP practices which have a higher rate of MDI prescribing as a priority and we’re really happy with the uptake so far.

I think the general feeling within GP practice teams is that if clinicians can explain the benefits to patients of swapping inhalers as well as the environmental impact then it’s a really positive step.”

The nurse-led project involves specialist respiratory nurses being placed within practices to carry out inhaler reviews.

Each practice is allocated 11 clinic days – 1 set up session and 10 patient review days to look at inhaler prescribing.

Feedback was collated as part of a report to understand the impact of the project, views were sought from both patients and practices and both were positive.

Mark added:

“Each person has a new inhaler approximately every other month so that’s six inhalers per year changed from an MDI to a DPI.

This is equivalent to CO2 produced driving from Shire Hall to Liverpool or three trees per year.”

Carol Stonham, Respiratory Nurse Specialist, added:

“The best way to reduce the carbon footprint associated with asthma medication is to optimise care so that symptoms are controlled and asthma does not flare up. That way, there is no need for unscheduled care.

The move to lower carbon footprint inhalers is also important and has to be done with consideration for each individual patient, how well their symptoms are controlled, their inhaler preference and how that fits into their personalised asthma action plan.”