New NHS collaboration supports optimisation of asthma management by reducing over-reliance on reliever inhalers and their carbon footprint
• Outcomes for the five million people living with asthma in the UK have are amongst the worst in Europe
• Over-reliance on blue inhalers is associated with an increased risk of asthma attacks, and a contributor to poor health outcomes
• Use of reliever inhalers drives 70% of greenhouse gas emissions (GHG) of all inhaler devices in the UK and per capita is nearly treble other European countries
• A new collaboration between NHS services in Hull and AstraZeneca aims to optimise asthma care and improve patient management– early results show nearly 7,000 fewer blue inhalers prescribed in seven months, equivalent to saving ~195 tonnes of CO2. ,
AstraZeneca, UK, November 2021: A first of its kind collaboration between the NHS in Hull and AstraZeneca is aiming to deliver improvements in care for thousands of people with uncontrolled asthma and reduce the associated carbon footprint. The SENTINEL programme aims to optimise the use of anti-inflammatory ‘preventer’ inhalers, which treat the underlying inflammation of asthma, while reducing the reliance on and prescribing of blue ‘reliever’ inhalers and the greenhouse gas emissions they produce. At the programmes’ core are the implementation of local asthma guidelines, delivery of targeted patient reviews, and provision of education packaged to clinicians and patients.
Early data from the first PCN in Hull shows a reduction in SABA* inhaler use, moving from a PCN with one of the highest uses nationally (98th percentile) to below the national average (41st percentile) in under four months. Changes in prescribing has reduced the number of blue inhalers used by nearly 7,000 units, equating to an offset of over 195,000 kg in CO2 emissions – in under six months and from just two PCNs.iv,v These initial findings highlight the potential opportunity to change aspects of respiratory care in other parts of the UK to support the delivery of asthma policies within the NHS Long term Plan and Greener NHS Strategy.
Dr Mike Crooks, Consultant Respiratory Physician “Over-reliance on blue ‘reliever’ medication contributes to poorer health outcomes and potentially avoidable emergency admissions. We hope healthcare professionals in Primary Care Networks will look at what we’re doing here in Hull and see the benefits it brings to both patients and the health system. We are hopeful of delivering long-term patient outcomes as well as the added benefit of reducing our carbon footprint. It has been clear that we need to help people living with asthma recognise what over-reliance on reliever inhalers is and to seek out an asthma review from their GP, nurse or pharmacist”
In the UK, anti-inflammatory inhalers are under-used in asthma while almost 2 in 5 patients are potentially over-reliant on their blue inhalers (prescribed three or more inhalers in a year).ii, Patients who are over-reliant on their blue inhalers have twice as many asthma attacks compared to those who don’t, regardless of their asthma severity.ii
Outcomes for the five million people living with asthma in the UK have stagnated for decades and are among the worst in Europe.i The SENTINEL programme, is currently running across six PCNs in Hull and East Riding, a region with ~40,000 asthma patients and some of the highest rates of reliever inhaler over-reliance in the country.v
Tom Keith Roach, President, AstraZeneca UK, said “Eliminating asthma attacks wherever possible should be a priority in improving asthma care in the UK. The encouraging results we’ve seen in Hull and Yorkshire show a path forward in making the changes needed to reduce over-reliance on SABA medication, which we know is putting patients at increased risk of asthma attacks. SENTINEL is a true collaboration between AstraZeneca, academia and the National Health Service that can be scaled nationally to implement much-needed change, which we hope will improve patient outcomes and simultaneously optimise healthcare utilisation.”
SENTINEL is supported by Yorkshire & Humber Academic Health Science Network (AHSN) as a programme that can drive further regional and national innovation which could improve patients’ lives and healthcare utilisation and resource – see here for a summary.
Harriet Smith, Yorkshire and Humber AHSN said “We are proud to be able to support this programme which provides benefits to both the patient and the healthcare system. The AHSN is committed to finding new innovations that will improve health outcomes and we act as a bridge between the NHS, industry and academia to encourage the adoption and spread of improved services at scale. We are therefore delighted with the results seen by our partners in Hull and we will be working to support further adoption of this programme across other parts of the region to help reduce the reliance on reliever inhalers.”
For more information on the quality improvement initiative undertaken in Hull and East Yorkshire in joint collaboration with AstraZeneca, visit https://hullasthma.co.uk/.
* Reliever or rescue inhalers are often blue in colour and contain short-acting-beta-agonist [SABA] medication.
Christian Petrovic, External Communications – firstname.lastname@example.org
About the NHS Long Term Plan and the Greener NHS Strategy
The NHS Long Term Plan aims to reduce the use of SABA where appropriate and support patients to receive the right medication. The Greener NHS Strategy aims to reduce 4-5% of the overall national carbon footprint and specifically the contribution of the carbon footprint attributed to inhaled medicines.
About Reliever inhalers and Green House Gases
In the UK the use of reliever inhalers drives 70% of greenhouse gas emissions (GHG) and the per capita is approximately treble or more than that of other large European countries, resulting in even higher GHG emissions.iii Nationally, over 15.5 million SABA inhalers are prescribed a year, 94% of these are known to contribute to a higher carbon footprint compared to other more sustainable inhalers.v, vi
About the AstraZeneca
AstraZeneca is a global, science-led biopharmaceutical company that focuses on the discovery, development and commercialisation of prescription medicines, primarily for the treatment of diseases in three therapy areas - Oncology, Cardiovascular, Renal & Metabolism and Respiratory. The Company also is selectively active in the areas of autoimmunity, neuroscience and infection. AstraZeneca operates in over 100 countries and its innovative medicines are used by millions of patients worldwide.
AstraZeneca operates in five different locations in the UK, where around 8,300 employees work in research and development, manufacturing, supply, sales and marketing. We supply 40 different medicines. The UK is also an important location for AstraZeneca’s clinical trials; in 2018, we undertook 201 trials in the UK, involving 376 centres and over 7,000 patients. For more information, please visit www.astrazeneca.co.uk