Improving respiratory (Asthma and COPD) outcomes for patients and reducing the environmental impact of inhalers.

Published on 8 August 2022

About the project

The NHS has a national ambition to deliver the world’s first net zero health service and respond to climate change, improving health outcomes now and for future generations.

Inhalers account for 3% of the total NHS Carbon footprint. Salbutamol metered dose inhalers (MDIs) are the single biggest source of carbon emissions from NHS medicines prescribing[i]. Dry powder inhalers (DPIs) and other newer types of inhalers like soft mist inhalers are less harmful to the environment than traditional metered dose inhalers (MDIs).

Patients in the United Kingdom experience poorer outcomes in terms of respiratory disease in comparison to comparable countries. Why Asthma Still Kills reports that high use of short acting beta agonists (salbutamol and terbutaline) and poor adherence in the use of inhaled corticosteroids in asthma suggests poor management, and these patients should be reviewed regularly to ensure good control[ii]. The UK has a higher rate of short acting beta agonist (SABA) overuse than other European countries which is associated with an increased risk of exacerbations and mortality[iii].

[i] Network Contract Directed Enhanced Service Investment and Impact Fund 2022/23: Updated Guidance March 2022


[iii] Janson C, Menzies-Gow A, Nan C, Nuevo J, Papi A, Quint JK, Quirce S, Vogelmeier CF. SABINA: An Overview of Short-Acting β2-Agonist Use in Asthma in European Countries. Adv Ther. 2020 Mar;37(3):1124-1135. doi: 10.1007/s12325-020-01233-0. Epub 2020 Jan 24. PMID: 31981105; PMCID: PMC7089727.

Project ambitions

The WMAHSN are currently scoping quality improvement tools that will:

  • Reduce reliance on short acting beta agonist inhalers
  • Increase the use of Inhaled Corticosteroid Inhalers
  • Increase use of inhalers that have a greener footprint
  • Improve outcomes for patients with respiratory disease
  • Reduce the environmental impact and carbon emissions of inhalers

Project team

Anna Edwards

Innovation Project Manager

Rabia Gowa

Innovation Programme Manager

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