Eco-Responsible Awareness Raising interventions To reduce the Use of Long-Acting MDIs and Carbon Footprint in a University Hospital Center (EARTH).

Background: There are very limited data studying strategies designed to enhance environmentally conscious MDI prescribing habits. This study aimed to evaluate the impact of a multicomponent strategy promoting more environmentally responsible inhaler prescribing practices on the use of long-acting MDIs.

Objectives: What is the impact of a multicomponent eco-responsible inhaled medication prescribing awareness program on the prescription rate of long-acting MDIs in hospitalized patients?

Methods: This interrupted time series was conducted by retrospectively collecting long-acting inhaler metrics from digitalized records before and after awareness raising interventions. The primary outcome was to assess the impact of the multicomponent awareness campaign on the proportion of long-acting MDIs relative to the total number of long-acting inhalers prescribed on all in-patient hospital wards. The secondary endpoint was to evaluate the difference in proportion of long-acting MDI prescriptions between hospital admission and discharge in selected wards.

Results: A total of 7452 inhalers was collected. A significant relative decrease in level of 20.1% (P = 0.017) was observed between the preintervention and postintervention periods (27.9% and 22.3%, respectively). The slope of the proportion of long-acting MDIs was not significantly different (-0.2%, P = 0.319). There was no significant difference in the level or slope between admission and discharge for the secondary outcome.

Conclusion and relevance: A 20.1% reduction in the prescription rate of MDIs could be observed following awareness interventions focused on eco-responsible inhaler prescribing in a hospital setting. This is explained mainly by an initial decrease in the number of prescriptions postintervention and that change remained stable over time.