[Climate conscious prescription of inhaled medication]

Abstract

The aim of the guideline on climate-conscious prescribing of inhaled medicines is to reduce the carbon footprint of the healthcare system. Chronic respiratory diseases such as asthma and COPD are at risk by climate change. At the same time while inhalants are used to treat these diseases, their use contributes to global warming in several ways. Metered-dose inhalers (MDIs) contain propellants that are potent greenhouse gases, while powder inhalers (DPIs) are considered a more environmentally friendly alternative.Factors such as individual preferences, abilities and skills play a decisive role in the individual selection of the most suitable inhalation system. The guideline provides assistance and recommendations for selecting the most suitable products, taking into account the environmental footprint of the available products.The guideline recommends inhaled therapy, preferably with DPI, for adolescents over the age of 12 and adults with obstructive pulmonary disease. The aim is to enable and inform a climate-conscious choice of therapy in order to reduce the use of emission-intensive DA. When prescribing DA, a preparation with a counter should be selected.A therapy review is required if patients require a prescription for short-acting β-mimetics (SABA) more than twice a year, as this indicates inadequate asthma control.Decision aids explain the differences between DA and DPI to find the optimal therapy. It also emphasises the importance of training for children and adolescents, as their ability to use inhalers varies.The implementation of the guideline is supported by various materials (slide sets, short version, information for patients, https://register.awmf.org/de/leitlinien/detail/053-059).