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The following is a summary of “Driving Sustainability in Asthma and COPD Management: Preventative Models and Green Prescribing in a Rural Primary Care Practice in England,” published in the April 2025 issue of Journal of Primary Care & Community Health by Donaldson et al. 

Asthma and COPD are common chronic respiratory conditions, with inhalers being the primary treatment. In the UK, metered-dose inhalers (MDIs) make up 70% of inhaler prescriptions, contributing significantly to the NHS’s carbon footprint and highlighting the need for green prescribing. 

Researchers conducted a prospective study to evaluate the impact of a quality improvement program on respiratory care, focusing on prescribing patterns, review completion rates, and transitioning patients from MDIs to lower-carbon alternatives while maintaining clinical outcomes. 

They implemented the initiative at a UK general practice in January 2020, focusing on staff education, restructuring respiratory consultations, and patient engagement. The program, guided by the “treatable traits” paradigm and best practice frameworks, aimed to optimize individualized care. Prescribing data, in-date respiratory review rates, and estimated carbon emissions were analyzed over 4 years (2020-2024) using OpenPrescribing.net. No formal assessment was conducted on the direct impact of education on prescribing behaviors. 

The results showed an in-date respiratory review rate exceeding 90%, reaching over 96% during the latest quality outcomes framework (QOF) period. Over 4 years, non-salbutamol MDI prescriptions decreased from 62.9% to 36.2%, aligning with national sustainability goals. Despite population growth, carbon emissions from inhalers were reduced, reflecting a shift to lower-carbon prescribing. 

Investigators demonstrated the feasibility of integrating sustainable prescribing into routine respiratory care, aligning with national health goals. Improvements in prescribing patterns and review rates were noted, but further research is needed to assess the impact of educational interventions on decisions and long-term outcomes. 

Source: journals.sagepub.com/doi/10.1177/21501319251334217