ArticleBMJ open2022
Turning green: the impact of changing to more eco-friendly respiratory healthcare - a carbon and cost analysis of Dutch prescription data.
Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 31 citations in OpenAlex.
- Pooled it
- Strategies and tactics to reduce the impact of healthcare on climate change: systematic review.BMJ (Clinical research ed.) · 2024Pooled it
- Estimation of carbon emissions from inhaled respiratory medicines in Ireland: a cross-sectional study from a national pharmacy claims database from 2020 to 2022.International journal of clinical pharmacy · 2026Article
- Prescription patterns of inhaler medications from 2017 to 2023: A retrospective study using Ontario administrative healthcare data.PloS one · 2026Article
- Patients' perspectives on ecologically sustainable health care in general practice: an experimental vignette and questionnaire study.BJGP open · 2025Article
- Environmentally friendly inhaler decision-making with personalized care in asthma and chronic obstructive pulmonary disease: a qualitative study.Exploratory research in clinical and social pharmacy · 2025Article
- Inhaler use and their carbon footprint in Germany: a 10-year analysis (2013-2022).BMJ open respiratory research · 2025Article
- Modelling the climate impact of inhalers and mitigation strategies: a population-based study in British Columbia, Canada (2015-2032).BMJ open respiratory research · 2025Article
- The role of environmental impact in healthcare providers' choices of inhalers for treatment of asthma and COPD: a discrete choice experiment.BMC primary care · 2025Article
- Trends in inhaler use and associated carbon footprint: a sales data-based study in Europe.BMJ open respiratory research · 2025Article
- Article
- Article
- How to reduce carbon footprints in asthma.ERJ open research · 2025Article
- [Inhaled Respiratory Therapy and Global Warming].Farmaceuticos comunitarios · 2025Observational
- Sustainability as an Intrinsic Moral Concern for Solidaristic Health Care.Health care analysis : HCA : journal of health philosophy and policy · 2024Article
- Reductions in inhaler greenhouse gas emissions by addressing care gaps in asthma and chronic obstructive pulmonary disease: an analysis.BMJ open respiratory research · 2023Article
- The environmental impact of inhaler replacement: A carbon footprint and economic calculation of the National Database of Health Insurance Claims in Japan.Journal of general and family medicine · 2023Article
- Climate change and respiratory disease: clinical guidance for healthcare professionals.Breathe (Sheffield, England) · 2023Review
- Environmental impact of inhaler devices on respiratory care: a narrative review.Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesDry powder inhalers (DPIs) and soft mist inhalers have a substantially lower global warming potential than pressurised metered-dose inhalers (pMDIs). To help mitigate climate change, we assessed the potential emission reduction in CO
designWe performed a descriptive analysis of prescription data from two national databases of two independent governmental bodies. First, we calculated the number of patients with chronic obstructive pulmonary disease (COPD) and asthma that were using inhalation medication (2020). Second, we calculated the number and total of daily defined doses of pMDIs and NPIs including DPIs and soft mist inhalers, as well as the number of dispensed spacers per patient (2020). Third, we estimated the potential emission reduction in CO
settingDutch respiratory healthcare. PRIMARY AND SECONDARY OUTCOME MEASURES: The carbon footprint of current inhalation medication and the environmental and financial impact of replacing pMDIs with NPIs.
resultsIn 2020, 1.4 million patients used inhalers for COPD or asthma treatment. A total of 364 million defined daily doses from inhalers were dispensed of which 49.6% were dispensed through pMDIs. We estimated that this could be reduced by 70% which would lead to an annual reduction in greenhouse gas emission of 63 million kg.CO2 equivalents saving at best EUR 49.1 million per year.
conclusionsIn the Netherlands, substitution of pMDIs to NPIs for eligible patients is theoretically safe and in accordance with medical guidelines, while reducing greenhouse gas emission by 63 million kg.CO2 equivalents on average and saving at best EUR 49.1 million per year. This study confirms the potential climate and economic benefit of delivering a more eco-friendly respiratory care.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.