P7 Sustainable care: what people with COPD are offered a lower carbon inhaler device and who is more likely to succeed in switching?

Inhalers contribute significantly to carbon emissions in healthcare. Metered Dose Inhalers (MDIs) have a larger carbon footprint compared to Dry Powder Inhalers (DPIs). As a result, the NHS has prioritized transitioning patients from MDIs to DPIs when appropriate. However, there is limited understanding of COPD patient characteristics that may determine a clinician’s decision to offer a switch and indeed whether the switch is a success or failure.Asthma + Lung UK asked people with a respiratory disease to complete a wide-ranging online survey in 2023. Participants were asked if they had been offered the opportunity to switch to a DPI, and if so if it had been successful. We compared demographic, economic and clinical factors between people who successfully switched versus those who changed back to an MDI.4,821 people with COPD replied (64.6% female; age 67.8±13.0). 1,767 (36.6%) were offered a switch from MDI to DPI of whom 1,573 (89%) accepted. There were no differences in gender, age, race, or income between those who had and had not been offered a switch. Those offered a DPI were more likely to have been aware of the carbon impact of inhalers (62.5% vs 47.9%) and had had planned healthcare attendances (63% vs 52.3%). The change to DPI was successful in 969 (61.6% of switchers). Unsuccessful switchers were more likely to be female, and have uncontrolled disease, with increased unplanned healthcare utilisation and exacerbation frequency. Awareness of the carbon impact of MDIs was not significantly different between the two groups (60.3% vs 63.6%).This data provides insight that most patients who expressed a view are willing to consider a switch in inhaler. Most patients offered a switch will succeed and those with well controlled COPD are those most likely to successfully change from an MDI to a DPI.