Introduction Inhaled therapy is widely used as mainstay treatment in chronic respiratory conditions, however the environmental impact of inhalers is rarely considered when prescribing inhalers. A recent BTS position statement “encourages all prescribers and patients to consider switching pMDIs to non-propellant devices whenever they are likely to be equally effective.”(1) Little is known about Patients’ or Physicians’ perspectives on making such a switch.
Methods A survey was carried out to assess the importance of three factors to consider, if changing to a different but equally effective inhaler – cost, carbon footprint and ease-of-use. Information about the typical costs and carbon footprints of inhalers was provided. 50 patients already using regular inhalers were randomly recruited via Respiratory Clinics at a district general hospital and Pulmonary Rehabilitation sessions. Responses were rated on a 5-point scale from not important to very important. The same survey was also completed by 50 medical professionals who regularly prescribe inhalers.
Results 80% of patients surveyed rated the ease-of-use as important or very important consideration when changing inhalers. The ‘cost’ and ‘carbon footprint’ of the inhaler were equally important to patients (3.4 out of 5); only 14% of patients indicated that carbon footprint was of no importance to them.
Physicians rated ease-of-use even higher than patients, with 96% deeming this as an important or very important factor. Physicians rated carbon footprint slightly less importantly (3.2) than cost (3.4) and also lower than patients rated carbon footprint. 14% of physicians thought that carbon footprint was of no importance.
Conclusions Patients and Physicians agree that ease-of-use is the most important factor when choosing a new inhaler. This appears to contradict the fact that overall patients make fewer errors using DPIs(2), while the majority of inhalers prescribed in the UK are pMDIs(3). The data suggests that patients rate carbon footprint more importantly than physicians. The carbon footprint of inhalers is an important factor for the majority of patients, which should encourage physicians to discuss this consideration with patients prior to commencing or changing inhalers.
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