Regular specialist care for severe asthma linked to reduced greenhouse gas emissions
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Key takeaways:
- Regular specialist care improves severe asthma patient outcomes.
- Greenhouse gas emissions associated with asthma exacerbations were reduced after specialist care.
SAN DIEGO — Greenhouse gas emissions associated with severe asthma care are a substantial portion of the health care carbon footprint in the U.K., according to a poster presented at the American Thoracic Society International Conference.
“This research aimed to describe the greenhouse gas emissions associated with severe asthma care in the U.K.,” Andrew Menzies-Gow, MD, global medical head, respiratory biologics, AstraZeneca, told Healio.
“Since severe asthma accounts for a substantial proportion of health care resource utilization in asthma, an understanding of the carbon footprint of its treatments may help identify strategies to reduce emissions whilst improving disease management,” he continued.
The retrospective observational study used medical records from the Clinical Practice Research Datalink Aurum, Hospital Episode Statistics and CO2 Equivalent Emissions data. Patients aged 12 years and older with an asthma diagnosis from January 2007 to March 2022 were included. Researchers defined instances of severe asthma based on each patient’s asthma medications and index date of the first combined high-dose inhaled corticosteroid with another controller medication.
Patients were labeled as having severe uncontrolled asthma after two or more exacerbations and with having regular specialist care if they had two or more respiratory specialist visits per year.
Greenhouse gas emissions were determined by quantifying carbon dioxide (CO2) equivalents tons per 10,000 person-years related to asthma health care resource utilization, exacerbations and asthma medications. These were calculated by inhaler device and other asthma treatments.
In total, 7,163 patients (mean age, 50.5 years; standard deviation, 16.8; 69% female) with severe asthma who were then labelled as having severe uncontrolled asthma and receiving regular specialist care were included in the analysis. The median time for transition from severe asthma to receiving regular specialist care was 2 years (interquartile range, 1-4). Researchers found that total greenhouse gas emissions for severe uncontrolled asthma increased and was about 20% higher than for severe asthma.
“The data confirmed that poorly controlled asthma is associated with increased morbidity and health care resource utilization,” Menzies-Gow said. “Asthma is poorly controlled in around half of those with asthma in the U.K., increasing the risk of hospital admission and severe illness as well as health care costs. It has been shown previously that uncontrolled asthma is associated with an approximately three-fold higher carbon footprint vs. patients whose disease in well controlled.”
After a transition to regular specialist care, the total CO2 equivalents dropped approximately 24%. Greenhouse gas emissions related to exacerbations and medication dropping 80% and 20%, respectively, when compared with severe uncontrolled asthma, according to Menzies-Gow.
“Higher greenhouse gas emissions for patients with severe uncontrolled asthma vs. those with severe asthma or under regular specialist care were mostly attributed to higher exacerbation- and medication-related carbon dioxide equivalents,” Menzies-Gow said.
The authors emphasized that their findings suggest that by addressing the burden of poorly controlled asthma, care-related carbon emissions may be significantly reduced. Addressing SUA with RSC may have this effect for many reasons.
“Regular specialist care for patients with severe asthma helped improve clinical outcomes,” Menzies-Gow said. “This could be via multiple factors, including improving asthma care through reducing inappropriate medicine usage and addressing inflammation with inhaled corticosteroids, better inhalation technique, better adherence and use of biologic therapy, etc.”
Menzies-Gow highlighted that implementing evidence-based guidelines into clinical practice is better for not only patient outcomes but also the environment.
“A well-controlled patient with asthma has a lower greenhouse gas footprint than a poorly-controlled patient,” he said. “Accelerated access to specialist care for patients with severe asthma could reduce asthma care-related greenhouse gas emissions.”