Turning green: the impact of changing to more eco-friendly respiratory healthcare – a carbon and cost analysis of Dutch prescription data
Objectives Dry powder inhalers (DPIs) and soft mist inhalers have a substantially lower global warming potential than pressurised metered-dose inhalers (pMDIs). To help mitigate climate change, we assessed the potential emission reduction in CO2 equivalents when replacing pMDIs by non-propellant inh...
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| Format: | Article |
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BMJ Publishing Group
2022-06-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/6/e055546.full |
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| author | Evelyn A Brakema johan Kooistra Niels Chavannes Paul Hagedoorn Pieter ten Have Peter van Hal Iris Wichers Pauline de Heer Hans C Ossebaard |
| author_facet | Evelyn A Brakema johan Kooistra Niels Chavannes Paul Hagedoorn Pieter ten Have Peter van Hal Iris Wichers Pauline de Heer Hans C Ossebaard |
| author_sort | Evelyn A Brakema |
| collection | DOAJ |
| description | Objectives Dry powder inhalers (DPIs) and soft mist inhalers have a substantially lower global warming potential than pressurised metered-dose inhalers (pMDIs). To help mitigate climate change, we assessed the potential emission reduction in CO2 equivalents when replacing pMDIs by non-propellant inhalers (NPIs) in Dutch respiratory healthcare and estimated the associated cost.Design We performed a descriptive analysis of prescription data from two national databases of two independent governmental bodies. First, we calculated the number of patients with chronic obstructive pulmonary disease (COPD) and asthma that were using inhalation medication (2020). Second, we calculated the number and total of daily defined doses of pMDIs and NPIs including DPIs and soft mist inhalers, as well as the number of dispensed spacers per patient (2020). Third, we estimated the potential emission reduction in CO2 equivalents if 70% of patients would switch from using pMDIs to using NPIs. Fourth, we performed a budget impact analysis.Setting Dutch respiratory healthcare.Primary and secondary outcome measures The carbon footprint of current inhalation medication and the environmental and financial impact of replacing pMDIs with NPIs.Results In 2020, 1.4 million patients used inhalers for COPD or asthma treatment. A total of 364 million defined daily doses from inhalers were dispensed of which 49.6% were dispensed through pMDIs. We estimated that this could be reduced by 70% which would lead to an annual reduction in greenhouse gas emission of 63 million kg.CO2 equivalents saving at best EUR 49.1 million per year.Conclusions In the Netherlands, substitution of pMDIs to NPIs for eligible patients is theoretically safe and in accordance with medical guidelines, while reducing greenhouse gas emission by 63 million kg.CO2 equivalents on average and saving at best EUR 49.1 million per year. This study confirms the potential climate and economic benefit of delivering a more eco-friendly respiratory care. |
| format | Article |
| id | doaj-art-b9536c65f1e64a71b5e831fd01d3a1e6 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-06-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-b9536c65f1e64a71b5e831fd01d3a1e62025-01-27T22:20:10ZengBMJ Publishing GroupBMJ Open2044-60552022-06-0112610.1136/bmjopen-2021-055546Turning green: the impact of changing to more eco-friendly respiratory healthcare – a carbon and cost analysis of Dutch prescription dataEvelyn A Brakema0johan Kooistra1Niels Chavannes2Paul Hagedoorn3Pieter ten Have4Peter van Hal5Iris Wichers6Pauline de Heer7Hans C Ossebaard8Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands2 Maarssen, NetherlandsDepartment of Public Health and Primary Care, Leiden University Medical Center, Leiden, The NetherlandsPharmaceutical Technology and Biopharmacy, University of Groningen, Groningen, Groningen, The NetherlandsNational Health Care Institute, Diemen, The NetherlandsNational Health Care Institute, Diemen, The NetherlandsDutch College of General Practitioners, Utrecht, The NetherlandsNational Health Care Institute, Diemen, The NetherlandsNational Health Care Institute, Diemen, The NetherlandsObjectives Dry powder inhalers (DPIs) and soft mist inhalers have a substantially lower global warming potential than pressurised metered-dose inhalers (pMDIs). To help mitigate climate change, we assessed the potential emission reduction in CO2 equivalents when replacing pMDIs by non-propellant inhalers (NPIs) in Dutch respiratory healthcare and estimated the associated cost.Design We performed a descriptive analysis of prescription data from two national databases of two independent governmental bodies. First, we calculated the number of patients with chronic obstructive pulmonary disease (COPD) and asthma that were using inhalation medication (2020). Second, we calculated the number and total of daily defined doses of pMDIs and NPIs including DPIs and soft mist inhalers, as well as the number of dispensed spacers per patient (2020). Third, we estimated the potential emission reduction in CO2 equivalents if 70% of patients would switch from using pMDIs to using NPIs. Fourth, we performed a budget impact analysis.Setting Dutch respiratory healthcare.Primary and secondary outcome measures The carbon footprint of current inhalation medication and the environmental and financial impact of replacing pMDIs with NPIs.Results In 2020, 1.4 million patients used inhalers for COPD or asthma treatment. A total of 364 million defined daily doses from inhalers were dispensed of which 49.6% were dispensed through pMDIs. We estimated that this could be reduced by 70% which would lead to an annual reduction in greenhouse gas emission of 63 million kg.CO2 equivalents saving at best EUR 49.1 million per year.Conclusions In the Netherlands, substitution of pMDIs to NPIs for eligible patients is theoretically safe and in accordance with medical guidelines, while reducing greenhouse gas emission by 63 million kg.CO2 equivalents on average and saving at best EUR 49.1 million per year. This study confirms the potential climate and economic benefit of delivering a more eco-friendly respiratory care.https://bmjopen.bmj.com/content/12/6/e055546.full |
| spellingShingle | Evelyn A Brakema johan Kooistra Niels Chavannes Paul Hagedoorn Pieter ten Have Peter van Hal Iris Wichers Pauline de Heer Hans C Ossebaard Turning green: the impact of changing to more eco-friendly respiratory healthcare – a carbon and cost analysis of Dutch prescription data BMJ Open |
| title | Turning green: the impact of changing to more eco-friendly respiratory healthcare – a carbon and cost analysis of Dutch prescription data |
| title_full | Turning green: the impact of changing to more eco-friendly respiratory healthcare – a carbon and cost analysis of Dutch prescription data |
| title_fullStr | Turning green: the impact of changing to more eco-friendly respiratory healthcare – a carbon and cost analysis of Dutch prescription data |
| title_full_unstemmed | Turning green: the impact of changing to more eco-friendly respiratory healthcare – a carbon and cost analysis of Dutch prescription data |
| title_short | Turning green: the impact of changing to more eco-friendly respiratory healthcare – a carbon and cost analysis of Dutch prescription data |
| title_sort | turning green the impact of changing to more eco friendly respiratory healthcare a carbon and cost analysis of dutch prescription data |
| url | https://bmjopen.bmj.com/content/12/6/e055546.full |
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