SusQI Case Study: Hywel Dda Medicines Optimisation Team, "Reducing the inhaler blues"

SusQI project completed as part of the Hywel Dda University Health Board Green Team Competition from September 2022-January 2023.

The NHS Wales Decarbonisation Strategic Delivery Plan, launched in March 2021, sets out NHS Wales’ plan for addressing the climate emergency declared by Welsh Government in 2019. Part of this plan focuses on the decarbonisation of inhalers. Wales has an ambitious target to reduce the proportion of metered dose inhalers (MDIs) from 70% to less than 20% by 2025, which, if achieved will reduce the amount of CO2 equivalent (CO2e) released into the atmosphere by 45,000 tonnes each year .

Hywel Dda Medicines Optimisation team worked collabortaively with a practice to reduce the carbon footprint of MDI inhalers being prescribed by changing appropriate patients from high carbon footprint MDIs to lower carbon footprint MDIs or DPIs as appropriate.

The Medicines Optimisation team conducted a search of Vision; the practice’s clinical record system, to find patients who were currently prescribed Salbutamol MDIs (branded or generic) as these have been identified as having a high carbon footprint. From these, we risk stratified the high risk patients , in order to assist the practice to prioritise patients for a face-to-face respiratory review. We also switched appropriat patients from high carbon inhaler to a lower carbon inhaler. 

We compared the CO2e of all MDIs at the start of the project with the CO2e once changed to lower carbon MDIs or DPIs. This included all the changes made from Ventolin®/generic Salbutamol to Salamol® , as well as any changes made as a result of the face-to-face reviews carried out by the practice. 

The total savings from changes made in project period 18,692 kgCO2e £248.58.

All aspects of the project could be replicated in different practices across the health board with potential CO2 and financial savings. Financial savings will only be achieved if inhaler usage and quantities prescribed are reduced due to better patient management of respiratory conditions.

Click here for more information on the Green Team Competition (including organisation impact reports).