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The UK's primary care sustainability network

Device choice

There are five projects in this section


Our first priority when considering a device change must always be to improve disease control. Reviewing those with poorly controlled disease and optimising their care, adherence and inhaler technique will reduce environmental impact whilst also improving disease management.

It is important that any decision to prescribe or change a patient’s asthma inhaler is the outcome of an individualised, shared decision-making conversation with patients and their carers. Patients should be reassured that the aim is to improve disease control whilst also reducing environmental impact. See our section on approach to consultations.

All device changes should be reviewed at approximately 4 -6 weeks, ideally face-to-face or via video if needed. If disease control worsens due to changing inhalers then review the choices, including whether to return to the previous inhaler.

Ideally patients should be on the same device type for preventer and reliever. Inhalers should be prescribed by brand name as devices are not interchangeable.

Target population

The projects in this section apply to patients aged 12yrs and over only

IIF targets and monitoring

The projects in this domain will help you to meet indicators ES-01 and ES-02 in the Network Contract DES Investment and Impact Fund 2022/23, and these are a good way to measure progress. The indicators reflect sustainability goals by setting targets for the proportion of Metered Dose Inhaler (MDI) prescriptions of all non-salbutamol inhaler prescriptions issued to patients aged 12 or over (relevant for Device Projects 1-4), and for mean carbon emissions per salbutamol inhaler prescribed (relevant for Device Project 5).

Education: Inhaler device choice

This resource discusses how to help your asthma patients select the best inhaler device for them.