New National Sustainable Asthma Care Roadmap released

The 25 million asthma puffers sold in Australia each year are taking a significant toll on the environment, creating an urgent need to rethink patient care offerings.
 
That is according to the new National Sustainable Asthma Care Roadmap, released this month, which has made a raft of recommendations to improve care for asthma patients at the same time as reducing the greenhouse gas emissions caused by respiratory inhalers.
 
Led by Asthma Australia and Deakin University, its recommendations include a shake-up of GP education, prescribing limits, a public awareness campaign, and a national program to appropriately dispose of the inhalers.
 
The report recommends the establishment of a data dashboard which monitors asthma care quality and emission trends, as well as an assessment of Australia’s total asthma care footprint.
 
It is also calling for regular updating of the Australian Asthma Handbook to ensure that clinical practice recommendations are based on the most recent evidence, and a national educational initiative for healthcare providers focusing on the prescribing of low-carbon inhaler options.
 
It recommends the creation of a national public awareness campaign, reducing the quantity and number of repeats on inhaler prescriptions, and the establishment of a nationwide program for collecting and appropriately disposing of pressurised metered-dose inhalers (pMDIs).
 
Following input from 50 expert organisations, the roadmap said that of the one in nine Australians living with asthma, half of all patients’ conditions are ‘poorly controlled’.
 
It said that with many medicines coming in pMDIs, these propellants are creating a large carbon footprint, when the same amount of medicine can be delivered by a dry powder inhaler with a reduced greenhouse impact.
 
‘Compelling evidence shows that transitioning to anti-inflammatory asthma medication regimens delivered using low-carbon devices can improve person-centred asthma outcomes while simultaneously reducing greenhouse gas emissions,’ the report concluded.
 
Dr Catherine Pendrey, Chair of RACGP Specific Interests Climate and Environmental Medicine, said the plan is a ‘win-win’ as it improves patient outcomes for people with asthma at the same time as reducing the environmental impact of asthma care.
 
‘Improving the outcomes for patients with asthma is good for the environment – there’s no real downside,’ she told newsGP.
 
‘By working with people to improve asthma control we’re improving their quality of life as well as reducing emissions … it’s critical that consumers are part of identifying solutions to reduce the emissions from asthma care.
 
‘It’s also about addressing accessibility so the medications that are more accessible are the ones that are the most effective and have lower emissions.’
 
Alarmingly, it found the greenhouse impact of the 25 million inhalers sold in Australia each year, of which around 80% are pMDIs, is the same as the emissions of 350,000 vehicles or 45,000 households.
 
To offset the equivalent CO₂ emissions, 60 million eucalyptus trees would need to be planted each year.
 
Dr Pendrey said she hopes the report will help her GP colleagues feel empowered to have conversations with their patients about their medications’ impacts on the environment.
 
‘We know that patients are interested in options that are good for the environment, provided they still deliver good care outcomes, and we know, in this case, that there’s a dual benefit for both patients and the environment,’ she said.
 
‘Asthma is one of the largest contributors to ill health for young people and we know that young people are one of the groups in society that will be most affected by climate change and are most concerned about it, so this is a conversation that patients and families want to be having.
 
‘It’s about education for clinicians and consumers, and it’s about aligning some of the funding and policy incentives so that environmentally friendly asthma care is the most accessible option.’
 
The report is part of the National Health and Climate Strategy, which included calls for action to improve respiratory health outcomes and reduce emissions from respiratory inhalers.
 
Dr Kerry Hancock, Chair of RACGP Specific Interests Respiratory Medicine, told newsGP that the report highlights recent changes in the evidence-based best practice management of asthma, as well as strategies to reduce the overall carbon footprint.
 
‘GPs maintain a very important role in working with their patients to achieve good asthma control to reduce the risk of severe exacerbations, hospitalisations and worsening lung function that occurs when asthma is not well controlled,’ she said.
 
‘They can do this for their patients whilst being mindful of the greenhouse affects.’
 
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