New patients
Opportunities for environmentally sustainable prescribing should be considered when prescribing inhalers for a new patient.
As there are significant differences in the global warming potential of different pMDIs, the following should be considered:
- use inhalers with a low global warming potential when they are as equally effective6
- where there is no alternative to a pMDI, lower volume HFA134a pMDI should be used in preference to large volume or HFA227ea pMDIs6
- prescribing decisions should be based on patient preference and ability to use the device. Ensure inhaler technique is taught and inspiratory flow may be assessed using an In-check® device
- patient should be counselled on expectations of treatment, signs of poor control and importance of adherence and attendance at review
- for patients with asthma use NICE: inhalers for asthma prescribing decision aid