Environmental Sustainability in Englands NHS Respiratory Prescribing; A grounded theory analysis to define a methodology for estimation of inhaler carbon footprint.

Abstract

Background The impact of climate change on health is increasing, as global warming continues to rise.1 Within the health and social care sector, pressurised metered dose inhalers (pMDIs) and breath-actuated pMDIs (BA-pMDIs) have been identified as a significant contributing factor to Englands National Health Service carbon footprint. 2 Methods A grounded theory study design was applied to formulate a process map and methodology for Inhaler carbon footprint estimation, utilising established inhaler carbon footprint values and pharmaceutical principles. Results A methodology has been developed to support estimation of inhaler carbon footprint values for those inhalers and refills, that do not have a manufacturers independently verified carbon footprint certificate. Conclusion Definitive Inhaler carbon footprint values, such as those reported here, are required to enable analysis and monitoring of prescribing against Net Zero targets. Further application can also support sustainability assessment and formulary decision making.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

This study did not receive specific funding, resource was allocated to this work stream through current funding from multiple primary care stakeholder CCGs.

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

Data Availability

All data produced in the present study are available upon reasonable request to the authors

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