Overuse of asthma reliever medication responsible for 250,000 tonnes of UK greenhouse gas emissions every year

New analysis of respiratory inhaler medicine use in the UK shows that 83% of all short-acting beta-2-agonist (SABA) relievers for asthma are prescribed to patients who are potentially overusing their reliever medication (prescribed ?3 inhalers/year).   The overuse of SABA relievers represents 9.24 million SABA prescriptions and is responsible for 250,000 tonnes of CO2 equivalent annually.

The prescription of three or more SABA asthma inhalers per year is associated with poor asthma control and approximately twice the number of attacks

These findings will be presented at the British Thoracic Society Winter Meeting and are based on SABA prescription and use data extracted from the UK study in the SABA Use IN Asthma (SABINA) global programme of harmonised, large-scale observational studies collected between 2007-2017.

The prescription of three or more SABA inhalers per year is associated with poor asthma control, approximately twice the number of exacerbations compared with low SABA users (prescribed 0-2 inhalers/year) and increased asthma-related healthcare utilisation.   Asthma is a chronic, variable, inflammatory disease affecting 5.4 million people in the UK (4.3 million adults) and can cause asthma attacks and symptoms including breathlessness and wheezing.   Every 10 seconds someone in the UK has a potentially life-threatening asthma attack with, on average, three people dying from asthma every day.

Alexander J K Wilkinson, Consultant in Respiratory and General Medicine, East and North Hertfordshire NHS Trust, Stevenage, UK and lead author of the study said: “Overuse of reliever inhalers in asthma is widespread in the UK and associated with an increased risk of exacerbations for patients, highlighting the importance of adopting strategies to improve disease control and reduce short-acting beta-2-agonist overuse.  This new analysis shows that reliever overuse is also a major contributor to greenhouse gas emissions in respiratory care, similar to driving an average diesel car for about 900 million miles.  These findings are important for informing clinical guidelines and healthcare policies to support improvements in asthma care while also realising carbon savings.”

Alex de Giorgio-Miller, Vice President, Medical & Scientific Affairs, AstraZeneca UK, said: “We know that the overuse of SABA ‘reliever’ inhalers is associated with an increased risk of severe asthma attacks, but this analysis highlights the scale of the problem we face in the UK, both in terms of poor health outcomes and the corresponding greenhouse gas burden.  By reducing over-reliance on SABA inhalers and improving asthma outcomes, we can also have an important positive impact on the environment.”

Further results from the analysis showed that SABA inhaler use drives 70% of greenhouse gas emissions (GHG) from inhaler devices in the UK.  The per capita use of all SABA reliever inhalers in the UK was approximately treble or more than that observed in other large European countries, resulting in even higher GHG emissions.