https://cpe.org.uk/quality-and-regulations/pharmacy-quality-scheme/
"Inhalers still account for approximately 3% of the NHS’ carbon footprint, mostly due to the propellants used to deliver the medications.
press and breathe pressurised metered-dose inhalers (pMDIs) currently use hydrofluorocarbon gases (HFCs or ‘F-gases’) as propellants. • When released from the inhaler, HFCs remain in the atmosphere for approximately 270 years and they are potent greenhouse gases between 1,300 and 3,350 times greater than CO2.
Used inhalers typically have 30% of the original propellant remaining in the canister.
While residual propellant gases in inhalers can be extracted, cleaned and reused in industrial equipment, such as air conditioning systems, they are being phased out of use in most applications because of their environmental impacts. • Inhalers returned to pharmacies for safe disposal will be incinerated at high temperature by NHS England and NHS Improvement’s waste contractor. This process destroys the propellant gases, so they don’t escape into the atmosphere. Steel and aluminium from inhaler canisters may be recovered and recycled at some incinerators."
For patients using inhaler:
Checked that all children aged 5 to 15 (inclusive) dispensed an inhaled press and breathe pMDI for asthma have a spacer device where appropriate, in line with NICE TA38.
Referred children aged 5 to 15 (inclusive) with asthma to an appropriate healthcare professional where this is not the case.
Personalised asthma action plan (PAAP) can help identify worsening asthma, support corrective action and advise patients and carers of how and when to seek help.
Referrals for patients using 3 or more bronchodilators in 6 months
patients with asthma, for whom three or more short-acting bronchodilator inhalers were dispensed without any corticosteroid inhaler within a six-month period have, since the last review point, been referred to an appropriate healthcare professional for an asthma review.
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