Ward based inhaler technique service reduces use and carbon footprint of short-acting beta-agonist (SABA) inhalers

<bold>Introduction:</bold> A ward based inhaler technique service achieves significant reductions in rates of asthma and COPD exacerbations and hospital admissions.[1] The impact on SABA inhaler usage has not previously been assessed. <bold>Aim:</bold> To determine the impact of this service on the use and carbon footprint of SABA inhalers. <bold>Methods:</bold> Patients admitted to respiratory wards with an exacerbation of asthma or COPD had their inhaler technique assessed and optimised through training or protocol-guided device changes. The number of SABA inhalers issued in primary and secondary care were compared for the 6-months before and after the intervention. <bold>Results:</bold> Data were available for 86 of 266 patients included in the original study. Use of mixed inhaler devices was more common on admission (usually dry powder inhaler (DPI) maintenance and pMDI reliever inhalers) than using all DPI or all pMDI devices (45, 7, 34 patients respectively). 19 patients using mixed devices agreed to change to use all DPI devices. The median number of SABA inhalers used in the 6 months prior to the intervention was higher for patients using mixed devices (5.5) than those prescribed all pMDI devices (4.0) or all DPI devices (2.4). Fewer SABA inhalers were issued after the intervention (400 vs. 376 over 6 months), and the carbon footprint of SABAs issued reduced significantly (10,060 vs. 7,685 kg CO₂e). <bold>Conclusions:</bold> Inhaler technique optimisation reduces the use of SABA inhalers. The carbon footprint reduced as more DPI SABAs were prescribed. Patients using mixed inhaler devices used more SABA inhalers and should be targeted to ensure consistent prescribing.