Awareness of green inhalers is limited among Irish prescribers

Awareness of green inhalers is limited among Irish prescribers <bold>Introduction:</bold> Inhalers account for a substantial proportion of global greenhouse gas (GHG) emissions, mostly due to the propellant (hydrofluroalkane) in metered dose inhalers (MDIs). Alternative devices, dry-powder inhalers (DPI) and soft mist inhalers (SMI), have 10-30 times lower carbon footprint than MDIs. In Ireland, inhalers account for an estimated 4% of healthcare emissions, reflecting high MDI usage. In 2019, MDIs accounted for 60% of prescribed inhalers nationally. <bold>Methods:</bold> A survey of green inhaler awarenesss was distributed via messaging application to all medical, nursing and physiotherapy respiratory team members in our institution. We audited inhaler dispensing from the hospital pharmacy over a 12 month period. <bold>Results:</bold> Of 35 respondents, 82% were able to identify MDIs, whereas only 60% and 51% correctly identified DPIs and SMIs respectively. Almost 40% were unaware of the greater carbon footprint with MDIs, while 75% reported that environmental considerations would influence their inhaler prescribing. MDIs accounted for 55.6% (n=4149) of dispensed inhalers over 12 months, amounting to 107,235kg of CO2 emissions. <bold>Discussion:</bold> Our study demonstrates a lack of awareness of the carbon footprint of inhalers among those involved in regular inhaler prescribing. Urgent education of prescribers is essential to reduce the effect on the environment. A toolkit developed by Irish Doctors for the Environment is to be incorporated into our hospital prescriber’s guide aiming to establish Tallaght University Hospital as the first Irish tertiary institution to implement a sustainable inhaler prescribing policy.