Evidence map›Paper›PMID 40903754›Full record

ArticleBMC primary care2025

The role of environmental impact in healthcare providers' choices of inhalers for treatment of asthma and COPD: a discrete choice experiment.

I G Arslan, M Vervloet, E W de Bekker-Grob, K Hek, B J Knottnerus, C Wagner, L van Eikenhorst

Abstract read
In one paragraph

Article in BMC primary care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

I G ArslanNetherlands Institute for Health Services Research (Nivel), Utrecht, the Netherlands. i.arslan@nivel.nl.
M VervloetNetherlands Institute for Health Services Research (Nivel), Utrecht, the Netherlands.
E W de Bekker-GrobErasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.
K HekNetherlands Institute for Health Services Research (Nivel), Utrecht, the Netherlands.
B J KnottnerusNetherlands Institute for Health Services Research (Nivel), Utrecht, the Netherlands.
C WagnerNetherlands Institute for Health Services Research (Nivel), Utrecht, the Netherlands.
L van EikenhorstNetherlands Institute for Health Services Research (Nivel), Utrecht, the Netherlands. l.vaneikenhorst@nivel.nl.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPressurised metered-dose inhalers (pMDIs), often prescribed for the treatment of COPD and asthma have a high global warming potential (GWP) compared to dry powder inhalers (DPIs) and soft-mist inhalers. Despite calls to switch from high to DPIs or soft-mist inhalers, prescriptions of pMDIs have increased in recent years. Understanding healthcare providers' preferences can help develop strategies to promote prescribing low GWP inhalers. This study aimed to determine healthcare providers' preferences when prescribing inhalers for asthma and COPD, including its GWP (i.e. environmental impact).

methodsA survey containing a discrete choice experiment was conducted. Primary care providers were repetitively asked to choose between scenarios of inhalers that differed in five attributes: multidose or unidose system (i.e. ease of use), reduction in number of exacerbations, side effects, out of pocket costs and GWP. A multinomial logit model was used to determine the relative importance of the attributes.

resultsA total of 76 healthcare providers (general practitioners (GPs), nurse specialists and nurse practitioners) completed the survey. On average, the attribute 'reduction in number of exacerbations' was most important in their choice for inhalers, followed by, 'side effects', 'GWP', 'out of pocket costs', and 'multidose or unidose system'. Healthcare providers were willing to accept a high GWP inhaler instead of a low GWP inhaler when the inhaler reduced the number of exacerbations and were willing to opt for low GWP inhaler with higher out of pocket costs instead of a high GWP inhaler with lower out of pocket costs.

conclusionsHealthcare providers valued clinical factors (i.e. reduction in number of exacerbations and low side effects) as most important when choosing inhalers for their patients with COPD or asthma, however GWP was also an important driver of choice. Understanding these preferences can support strategies to support sustainable inhalers for COPD and asthma, contributing to climate change mitigation. For example by enhancing the provision of information regarding inhaler GWP, while ensuring that clinical effectiveness remains the primary focus.

Indexed as

AsthmaAttitude of Health PersonnelChoice BehaviorEnvironmentHealth PersonnelMetered Dose InhalersNebulizers and VaporizersPulmonary Disease, Chronic ObstructiveAdministration, InhalationAdultDry Powder InhalersFemaleHumansMaleMiddle AgedNurse PractitionersAsthmaCarbon footprintClimate changeCOPDDiscrete choice experimentGeneral practiceInhalerPreferences

Identifiers

PMID40903754
PMCPMC12406421

What Socratic holds

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LicenceCC BY
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Registered trials

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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.