Evidence map›Paper›PMID 41239014›Full record

ArticleInternational journal of clinical pharmacy2026

Estimation of carbon emissions from inhaled respiratory medicines in Ireland: a cross-sectional study from a national pharmacy claims database from 2020 to 2022.

Hafsa Kanwal, Umm-E-Kalsoom, Amjad Khan, Theo Ryan, James Quinn, Cristin Ryan

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Article in International journal of clinical pharmacy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1 · What the graph read from it

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Hafsa KanwalDepartment of Pharmacy, Quaid-I-Azam University, Islamabad, Pakistan.
Umm-E-KalsoomDepartment of Pharmacy, Quaid-I-Azam University, Islamabad, Pakistan.
Amjad KhanDepartment of Pharmacy, Quaid-I-Azam University, Islamabad, Pakistan. amjadkhan@qau.edu.pk.
Theo RyanThe School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, University of Dublin, Dublin, Ireland.
James QuinnThe School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, University of Dublin, Dublin, Ireland.
Cristin RyanThe School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, University of Dublin, Dublin, Ireland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionInhaled therapies are essential for managing asthma and chronic obstructive pulmonary disease (COPD), but device choice carries environmental consequences. Inhaler devices influence climate impact; propellant-based metered-dose inhalers (MDIs) have substantially higher carbon footprints than non-propellant inhalers (NPIs). Ireland has committed to net-zero greenhouse gas emissions by 2050, making prescribing practices a relevant focus for mitigation.

aimTo describe national dispensing patterns of inhaled respiratory medicines and estimate associated CO₂-equivalent (CO₂e) emissions in Irish primary care, 2020-2022.

methodWe analysed Health Service Executive-Primary Care Reimbursement Service (HSE-PCRS) dispensing data for inhaled respiratory medicines (ATC R03) products. Items were classified as MDIs or NPIs. Trends of inhalers use were expressed as year-on-year inhalers dispensed. We conducted scenario analysis in which 10%, 25%, and 50% of 2022 MDIs use were replaced with NPIs to calculate the reduction in carbon emissions. Notably, PCRS schemes cover ~ 43% of the Irish population (predominantly older adults and a lower income group).

resultsBetween 2020 and 2022, a total of 9.94 million inhalers were dispensed under HSE-PCRS schemes, with annual volumes rising from 3.04 million (2020) to 3.60 million (2022). MDIs increased from 1.50 million (2020) to 1.79 million (2021) and 1.95 million (2022), while NPIs declined - 15.7% in 2021 and then rebounded + 26.8% in 2022. The MDIs share of all inhalers changed from 49.2% (2020) to 57.9% (2021) to 54.2% (2022) for which estimated MDIs carbon emissions were 28.6, 34.6, and 37.6 kt CO₂e, respectively. This emission was accounted for 95-96% of inhaler-related emissions annually. In scenario analyses, replacing 10%, 25%, and 50% of 2022 MDIs use with NPIs resulted in estimated emission reduction of ~ 3.6, 8.9, and 17.9 kt CO₂e, respectively.

conclusionThe results show how MDIs influence the carbon footprint of the health sector and they encourage healthcare providers to support sustainable alternatives. When clinically appropriate, choosing sustainable devices provides significant, short-term CO2 savings without sacrificing treatment.

Indexed as

Carbon FootprintRespiratory System AgentsAdministration, InhalationAdultAgedCross-Sectional StudiesDatabases, FactualFemaleHumansIrelandMaleMetered Dose InhalersMiddle AgedPulmonary Disease, Chronic ObstructiveRespiratory System AgentsAsthmaCarbon footprintChronic obstructiveDose inhalersDrug prescriptionsDry powder inhalersInhalation therapyMeteredPulmonary disease

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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.