Family Medicine Bets On Sustainable Inhalers

The Spanish Society of Family and Community Medicine (semFYC) has published ‘What to do and not to do in planetary health’, a document prepared by the Planetary Health Working Group of the scientific society of Primary Care and which seeks to be a guide ” as practical as possible” for the doctors of the first level of care.


“The objective is that you apply it in your day to day: in the routine of your health center or office, when you value your patients, when recommending prevention and health promotion activities, when prescribing or in activities with your community”, they point out, adding that “the time has come to include in your daily life the perspective of planetary healthbecause there is no PLANET B”.

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Among the ten pieces of advice provided by specialists in Family and Community Medicine (FCM), the fifth is committed to “not prescribing pMDI inhalers if there is a better alternative”. The authors of this section, Anna Fernández Ortiz and María del Campo Giménez, state that “all drugs have an impact on the environment: the carbon footprint of production, storage, packaging, transport and waste management “.

It is estimated that the change from a pMDI system to DPI or SMI, keeping the same active ingredient, represents a reduction of the carbon footprint of 95-98% per inhaler

However, they add, inhalers have another added factor: the propellant of pressurized systems pMDI (pressurized Metered Dose Inhaler), hydrofluorocarbon gases (HFC), with a more powerful greenhouse effect than CO2.


In Spain, pMDIs represent close to 50% of the total bronchodilators used, which is equivalent to 400,000 tons of CO2. Hence the importance of trying to minimize the use of this type of pMDI inhalers in favor of systems that do not use gases with greenhouse effect, such as dry powder inhalers (Dry Powder Inhaler, DPI) and fine mist inhalers (Soft Mist). Inhaler, SMI).


It is estimated that the change from a pMDI system to DPI or SMI, keeping the same active ingredient, represents a reduction in the carbon footprint of 95-98% per inhaler. For example, among short-acting beta-agonist drugs, one application of salbutamol in a pMDI device is equivalent to 60.4 g CO2 eq; Taking into account that up to 8 daily applications can be used, it would be equivalent to 176.37 kg CO2 eq per year, which is the same as a car trip of 978.5 km.


PRESCRIPTION INHALER


If the characteristics of the patient allow it, it is recommended to prescribe DPI and SMI, with a lower carbon footprint (up to 18 times, in the case of DPI). These devices are just as effective and cost-effective as pMD.

If the characteristics of the patient allow it, it is recommended to prescribe DPI and SMI, with a lower carbon footprint (up to 18 times, in the case of DPI)

The prescription of the type of device will always be made taking into account the characteristics of the patient and their preferences regarding the type of device, so it is useful to have support materials for shared decision-making.

Because we all need health… ConSalud.es

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