Abstract

Introduction
There is a significant environmental impact of inhaler use, both from the carbon footprint of propellants and plastic waste from discarded inhalers.
Metered dose inhalers contain propellants that are greenhouse gases thousands of times more powerful than carbon dioxide. These propellants contribute to nearly 4% of the entire NHS carbon footprint and about 25% of the carbon footprint associated with general practice prescribing1. Adequate disposal of inhalers is crucial to prevent propellant gases from escaping into the atmosphere. A study by a major pharmaceutical company revealed that 29% of inhalers disposed had leftover medication in them2. Additionally, a study conducted at Hill View Surgery found that 87% of patients were unaware that inhalers could be recycled and disposed of them in domestic waste3.
Quality Improvement
Digital healthcare services have expanded and have the potential to positively impact the environment. As a digital healthcare provider offering an asthma service, we reviewed the current online advice for patients on our website and the information provided upon prescribing treatment. We found that no information was provided on the safe disposal of inhalers or their environmental impact. Consequently, we updated our website to include information on the safe disposal of inhalers and incorporated advice on this topic into patient communications when prescribing inhalers.
Discussion
As digital healthcare continues to grow, we have a responsibility to consider its environmental impact. Providing patients with information on safe disposal of inhalers and their environmental implications is a step towards greener online practice. This initiative aims to empower patients to reduce their carbon footprint.

References
1. Smith J et al. Reducing Our Carbon Footprint of Inhaler Prescribing.
https://s40639.pcdn.co/wp-content/uploads/Reducing-Carbon-Footprint-of-Inhaler-Prescribing-v3.3.2.pdf
2. Brenner B. What do I do with old inhalers? 2016. https://www.medprodisposal.com/what-do-with-old-inhalers/
3. Sivarajasingam V. Understanding patients’ knowledge of inhaler recycling. https://bjgplife.com/understanding-patients-knowledge-of-inhaler-recycling/