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3. Targeting highest carbon footprint preventer inhalers

This project aims to reduce the use of the highest carbon footprint combination inhalers (Flutiform pMDI and Symbicort pMDI). It can be adapted to offer patients specific consultations or to integrate a discussion about device choice into routine reviews, depending on your practice staffing and resources. 

Please note Symbicort Turbohaler is a dry-powder inhaler and is a low-carbon choice.

The process

Step 1: Search for all patients with the highest carbon-emitting inhalers on repeats

Create list of all patients aged 12+ with asthma Flutiform pMDI and Symbicort pMDI inhalers on repeats.

Resource:

Step 2: Invite patients to consultations

Contact all patients to offer consultation to switch inhalers to a lower carbon option.

Contact patients to provide information on lower carbon options to read before their appointment.

Resources:

Alternative step 2: Set an alert on the patient record to show that lower carbon inhaler options are available

Create a visibility rule flagging patient for consideration of lower carbon options at next review. This has been built into the PCIT Asthma Template.

If you are doing this, send patients information about inhalers and the environment so they are primed for their next review.

Resources:

Step 3: Perform consultations to discuss using a lower carbon inhaler

Depending on the number of patients in your practice, consider the workload, how this will be managed and by whom.

Use the Education videos and the Greener Practice Guide to support you.

In this consultation inhaler technique must be discussed and checked by a competent healthcare professional. Asthma UK videos on inhaler technique are an excellent resource to share with patients.

Resources:

Step 4: Follow-up patients

At the point you change an inhaler device you need to follow-up all patients at 4 – 6 weeks to review the change. You could code this in the notes.

TIP: add patients who have changed inhaler device type to a waiting list for follow-up .

Step 5: Measure your impact

Measure your carbon savings, monitor your progress.

Resource:

Resources

SMS templates

Changing to a lower carbon inhaler (if inviting directly to appointment)

SMS 1 of 2:
You may be able to change to a lower carbon footprint inhaler that is better for the environment?  For more info, head to www.greeninhaler.org
 If you are interested, please book an asthma review.

SMS 2 of 2:
To read more about asthma, your inhalers and the environment, read this leaflet https://bit.ly/3fSys0h or watch this video https://bit.ly/3T90yTn

AccuRx SMS 1 of 1:
We’re offering patients the opportunity to change their regular inhalers to a different type with a lower carbon footprint. To learn more read this leaflet https://bit.ly/3fSys0h or watch this video https://bit.ly/3T90yTn. You can also head to www.greeninhaler.org
If you’re interested, please contact reception to book an asthma review to discuss further.
OR
If you’re interested, please reply “YES” & we’ll contact you to make an appointment.

—–

Changing to a lower carbon inhaler (if setting visibility alert)

SMS 1 of 2:
You may be able to change to a lower carbon footprint inhaler that is better for the environment. If interested, discuss at your next asthma review.

SMS 2 of 2:
To learn more about inhalers and the environment read this leaflet https://bit.ly/3fSys0h, watch this video https://bit.ly/3T90yTn or go to www.greeninhaler.org

AccuRx SMS 1 of 1:
We’re offering patients the opportunity to change their regular inhalers to a different type with a lower carbon footprint. For more info, read this leaflet https://bit.ly/3fSys0h, watch this video https://bit.ly/3T90yTn or go to www.greeninhaler.org
If you’re interested, please speak to the nurse or doctor at your next asthma or medication review.

—–

Follow-up after change in inhaler

SMS 1 of 2:
We hope you are getting on well with your new inhaler. If there are any issues, please [book a review with asthma nurse/ doctor].

SMS 2 of 2:
Remember, if you’re needing your blue inhaler 3 or more times per week, this means your asthma treatment could be improved and you should book an asthma review as soon as possible.

AccuRx SMS:
We hope you are getting on well with your new inhaler. If there are any issues, please book a review. Remember, if you’re needing your blue inhaler three or more times per week, this means your asthma treatment could be improved and you should book an asthma review as soon as possible. Learn more about asthma control from this leaflet https://bit.ly/3EmhyRT or watch this video https://bit.ly/3Vaqfoh

Letter templates

Targeting the highest carbon inhalers

Dear Patient,

As part of our practice commitment to provide excellent care to our patients and to protect our planet, we are reviewing the prescriptions for some inhalers.

Which of my inhalers does this affect?
This affects your preventer inhaler, which you take every day to reduce your symptoms of asthma. We are looking at your prescription for one of the following inhalers:

  • Flutiform (50micrograms/dose / 5micrograms/dose, 125micrograms/dose / 5 micrograms/dose or 250micrograms/dose / 10micrograms/dose)
  • Symbicort (100 micrograms/ dose 3micrograms/dose or 200micrograms/dose / 6micrograms/ dose) pressurised inhaler

Why are you reviewing these prescriptions?
Metered dose (or aerosol spray) inhalers contain propellants to deliver medication to the airways. These propellants are powerful greenhouse gases that contribute to climate change.  The inhalers listed above have a higher carbon footprint compared to other inhalers because of the particular propellant gas they use. There are alternative inhalers which offer the same medication to your airways but have a much lower carbon footprint.

What are my options for changing?
You have two options for changing. You can change to an inhaler which you use in the same way as your current inhaler but uses a different gas which has a lower carbon footprint. You can also change to a dry-powder inhaler which doesn’t use propellant gas to deliver the medication to your lungs and so has an even lower carbon footprint but it requires a different technique to use.

Where can I get more information?

Foe more information about asthma, inhalers and the environment please read this leaflet https://bit.ly/3fSys0h or watch this video https://bit.ly/3T90yTn. You can also look online at www.greeninhaler.org

What do I need to do now?
If you are interested in speaking to our healthcare professional about changing your inhaler prescription to a lower carbon option, please contact reception to make an appointment.

OR

Please have a read of the information provided and write down any questions you may have. You will be contacted in the usual way for your asthma medication review, and at this time your nurse/ doctor will discuss changing your inhaler prescription with you if appropriate.

Thanks

[Practice name/ lead clinician name]