福莫特罗
布地奈德
医学
沙丁胺醇
吸入器
析因分析
碳足迹
哮喘
干粉吸入器
麻醉
内科学
温室气体
生态学
生物
作者
Lee Hatter,Mark Holliday,Allie Eathorne,Pepa Bruce,Ian Pavord,Helen K. Reddel,Robert J. Hancox,Alberto Papi,Mark Weatherall,Richard Beasley
出处
期刊:The European respiratory journal
[European Respiratory Society]
日期:2024-04-12
卷期号:64 (1): 2301705-2301705
被引量:8
标识
DOI:10.1183/13993003.01705-2023
摘要
Introduction The use of pressurised metered-dose inhalers (pMDIs) and asthma exacerbations necessitating healthcare reviews contribute substantially to the global carbon footprint of healthcare. It is possible that a reduction in carbon footprint could be achieved by switching patients with mild asthma from salbutamol pMDI reliever-based therapy to inhaled corticosteroid-formoterol dry powder inhaler (DPI) reliever therapy, as recommended by the Global Initiative for Asthma. Methods This post hoc analysis included all 668 adult participants in the Novel START trial, who were randomised 1:1:1 to treatment with as-needed budesonide/formoterol DPI, as-needed salbutamol pMDI or maintenance budesonide DPI plus as-needed salbutamol pMDI. The primary outcome was carbon footprint of asthma management, expressed as kilograms of carbon dioxide equivalent emissions (kgCO 2 e) per person-year. Secondary outcomes explored the effect of baseline symptom control and adherence (maintenance budesonide DPI arm only) on carbon footprint. Results As-needed budesonide/formoterol DPI was associated with 95.8% and 93.6% lower carbon footprint compared with as-needed salbutamol pMDI (least-squares mean 1.1 versus 26.2 kgCO 2 e; difference −25.0, 95% CI −29.7 to −20.4; p<0.001) and maintenance budesonide DPI plus as-needed salbutamol pMDI (least-squares mean 1.1 versus 17.3 kgCO 2 e; difference −16.2, 95% CI −20.9 to −11.6; p<0.001), respectively. There was no statistically significant evidence that treatment differences in carbon footprint depended on baseline symptom control or adherence in the maintenance budesonide DPI arm. Conclusions The as-needed budesonide/formoterol DPI treatment option was associated with a markedly lower carbon footprint than as-needed salbutamol pMDI and maintenance budesonide DPI plus as-needed salbutamol pMDI.
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