A Patient-Centered and Visually Attractive Toolkit Adapted to Children and Youth to Reduce Inhaler Impact on Carbon Footprint in Ambulatory and Outpatient Settings

A Patient-Centered and Visually Attractive Toolkit Adapted to Children and Youth to Reduce Inhaler Impact on Carbon Footprint in Ambulatory and Outpatient Settings
1) Introduction/Background: Carbon footprint (expressed in carbon dioxide equivalent, CO2e) is the preferred method to measure our impact on climate change. Healthcare represents 4.6% of total Canadian greenhouse gases emissions, and in this category, pharmaceuticals is making up to 25%. Pressurized Metered-dose Inhalers (pMDIs), are known to have a higher carbon footprint impact than their primary alternative, the Dry Powder Inhalers (DPIs), due to their liquified gases called hydrofluoroalkanes (HFAs). In a recent REB approved project, we completed a chart
review to examine the prescribing of inhalers in our pediatric respirology clinic, from January 1, 2022, to Dec 31st, 2022. Our research project highlighted that 92.9% of a year of inhaler prescriptions in our respirology clinic were pMDI inhalers with a high switchability potential to DPIs, if deemed clinically feasible. We estimated that switching 30% of salbutamol prescriptions from MDI to DPI could save around 16 metric tonnes of eCO2 emissions, an equivalent to 6 flights round trips between Toronto and Tokyo. As we were planning to share knowledge to our peers and influencing change on MDIs to PDIs prescription, when clinically safe, we could only find toolkits for a sustainable prescribing and usage of inhalers in the adult population but none that were adapted and patient-centered for the pediatric population. This is an opportunity to collaborate with clinicians, in a carbon stewardship model, and expand a proven carbon
reduction model into tools, adapted to the pediatric population.
2) Purpose: The purpose of this quality improvement
project is to design and share, a video, a handout and a decision tree, adapted to the pediatric population, as tools to simplify decision making processes in inhalers prescription by healthcare professionals.

Faculty Supervisor:

Norah McRae

Student:

Partner:

Children's Hospital of Eastern Ontario

Discipline:

Life Sciences

Sector:

Health and Related Sciences & Technology

University:

University of Waterloo

Program: