Reducing the environmental impact of inhalers in primary care

Climate change is having a negative effect on our health and on our planet. The NHS has made a commitment to achieve net zero greenhouse gas emissions (GHGE) by 2050 as a way of addressing this. Switching pressurised metered dose inhalers (pMDIs) to dry powder inhalers (DPIs) has the potential to significantly reduce GHGEs. The primary aim of this systematic review was to establish how to make sustainable inhaler changes in primary care that do not compromise patient care and outcomes. pMDI devices have a significantly higher global warming potential than DPIs, but the latter are not suited to everyone. In patients unsuited to DPI devices, changing prescribing habits can help to lower emissions. Returning inhalers to pharmacies for incineration also lowers global warming potential. DPI devices are easier to use and are linked with improved health outcomes. It is possible to lower the carbon footprint of inhalers by switching pMDI to DPI, and through education and changed prescribing habits.