P175 The true cost of switching to low global-warming potential inhalers. An analysis of NHS prescription data in england

Braggins, Rory; Wilkinson, A

doi:10.1136/thorax-2018-212555.332

Cited by 3 publications

(2 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These results are in accordance with earlier studies8 9 22 but we were relatively stringent in our eligibility criteria (which patients are able to change safely) and more selective as to what brands to include for the financial impact estimation. Obviously the outcomes refer to Dutch respiratory healthcare, its specific patient population and medication use.…”

Section: Discussionsupporting

confidence: 91%

Turning green: the impact of changing to more eco-friendly respiratory healthcare – a carbon and cost analysis of Dutch prescription data

et al. 2022

View full text Add to dashboard Cite

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 CO2 equivalents when replacing pMDIs by non-propellant inhalers (NPIs) in Dutch respiratory healthcare and estimated the associated cost.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 CO2 equivalents if 70% of patients would switch from using pMDIs to using NPIs. Fourth, we performed a budget impact analysis.SettingDutch respiratory healthcare.Primary and secondary outcome measuresThe 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.

show abstract

Section: Discussionsupporting

confidence: 91%

Turning green: the impact of changing to more eco-friendly respiratory healthcare – a carbon and cost analysis of Dutch prescription data

et al. 2022

View full text Add to dashboard Cite

show abstract

“…These results are in accordance with earlier studies [8, 9, 22] but we were relatively stringent in our eligibility criteria (which patients are able to change safely) and more selective as to what brands to include for the financial impact estimation. Obviously the outcomes refer to Dutch respiratory health care, its specific patient population and medication use.…”

Section: Discussionsupporting

confidence: 91%

Turning green: the impact of changing to more eco-friendly respiratory healthcare. A carbon and cost analysis of Dutch prescription data

Have

Hal

Wichers

et al. 2021

Preprint

View full text Add to dashboard Cite

ObjectivesDry powder inhalers (DPIs) and soft mist inhalers have a substantially lower global warming potential than pressurized metered-dose inhalers (pMDIs). To help mitigate climate change, we assessed the potential emission reduction in CO2-equivalents when replacing pMDIs by non-propellant inhalers in Dutch respiratory healthcare, and estimated the associated costs.DesignWe performed a four-step analysis based on data from two national databases of two independent governmental bodies (the Dutch National Healthcare Institute and the Dutch Healthcare Authority). First, we calculated the number of patients with chronic obstructive pulmonary disease and asthma that were using inhalation medication (2020). Second, we calculated the number and total of daily defined doses of pMDIs and non-propellant inhalers (NPIs) that include dry powder inhalers and soft mist inhalers, as well as the number of spacers per patient dispensed by non-hospital based pharmacies in 2020. Third, we estimated the potential reduction in greenhouse gas emission if 70% of patients would switch from using pMDIs to using NPIs as eco-friendly alternatives. Fourth, we performed a budget impact analysis.ResultsIn 2020, 1.4 million patients used inhalers for COPD or asthma treatment. A total of 460 million defined daily doses (DDDs) from inhalers were dispensed, of which – after the exclusion of nebulizers – 50.4% through pMDIs. We estimated that this usage could be reduced by 70% which would lead to an annual reduction in greenhouse gas emission of 77 - 84 million kg. CO2eq. saving at best EUR 49.8 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 80 million kg. CO2eq. on average and saving at best EUR 49.8 million per year. This study confirms the potential climate and economic benefit of delivering a more eco-friendly respiratory care.Strengths and limitations of this studyGiven availability and reliability of the data, the present analysis can easily be replicated elsewhere which allows for international comparison and aggregation.Implementation challenges remain underexposed.

show abstract

The Web-Based Pain-at-Work Toolkit With Telephone Support for Employees With Chronic or Persistent Pain: Protocol for a Cluster Randomized Feasibility Trial (Preprint)

Blake,

Chaplin,

Wainwright

et al. 2023

Preprint

View full text Add to dashboard Cite

BACKGROUND Chronic or persistent pain affects one’s ability to work or be productive at work, generating high societal and economic burden. However, the provision of work-related advice and support for people with chronic pain is variable or lacking. The Pain-at-Work (PAW) Toolkit was cocreated with people who live with pain, health care professionals, and employers. It aims to increase knowledge about employee rights and how to access support for managing a painful chronic condition in the workplace and provides advice on lifestyle behaviors that facilitate the management of chronic pain. OBJECTIVE We aimed to establish the feasibility of conducting a definitive cluster randomized controlled trial comparing access to the PAW Toolkit and telephone support calls from an occupational therapist (PAW) with treatment as usual (ie, standard support from their employer). Our primary outcomes are establishing parameters of feasibility, acceptability, usability, and safety of this digital workplace health intervention. We will assess the candidate primary and secondary outcomes’ feasibility and test research processes for a definitive trial. METHODS This is an open-label, parallel 2-arm pragmatic feasibility cluster randomized controlled trial with exploratory health economics analysis and a nested qualitative interview study. We aim to recruit 120 participants from at least 8 workplace clusters (any type, >10 employees) in England. The recruitment of workplaces occurs via personal approach, and the recruitment of individual participants is web based. Eligible participants are vocationally active adults aged ≥18 years with internet access and self-reporting chronic pain interfering with their ability to undertake or enjoy productive work. A restricted 1:1 cluster-level randomization is used to allocate employment settings to PAW or treatment as usual; participants are unblinded to group allocation. Following site- and individual-level consent, participants complete a web-based baseline survey (time 0), including measures of work capacity, health and well-being, and health care resource use. Follow-up is performed at 3 months (time 1) and 6 months (time 2). Feasibility outcomes relate to recruitment; intervention fidelity (eg, delivery, reach, uptake, and engagement); retention; and follow-up. Qualitative evaluation (time 2) is mapped to the Capability, Opportunity, Motivation–Behavior model and will explore intervention acceptability to employees and employers, along with individual and contextual factors influencing the delivery and uptake of the intervention. RESULTS Ethics approval was obtained in March 2023. Trial recruitment began in June 2023. CONCLUSIONS The PAW Toolkit is the first evidence-based digital health intervention aimed at supporting the self-management of chronic or persistent pain at work. This study will inform the design of a definitive trial, including sample size estimation, approaches to cluster site identification, primary and secondary outcomes’ selection, and the final health economic model. Findings will inform approaches for the future delivery of this digital health intervention. CLINICALTRIAL ClinicalTrials.gov NCT05838677; https://clinicaltrials.gov/study/NCT05838677 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/51474

show abstract

P175 The true cost of switching to low global-warming potential inhalers. An analysis of NHS prescription data in england

Cited by 3 publications

References 0 publications

Turning green: the impact of changing to more eco-friendly respiratory healthcare – a carbon and cost analysis of Dutch prescription data

Turning green: the impact of changing to more eco-friendly respiratory healthcare – a carbon and cost analysis of Dutch prescription data

Turning green: the impact of changing to more eco-friendly respiratory healthcare. A carbon and cost analysis of Dutch prescription data

The Web-Based Pain-at-Work Toolkit With Telephone Support for Employees With Chronic or Persistent Pain: Protocol for a Cluster Randomized Feasibility Trial (Preprint)

Contact Info

Product

Resources

About