JDS Evans is a busy independent community pharmacy located in Newport. We have always attempted to be a green as possible and applied to join the pilot scheme launched by Welsh Government called “Greener Primary Care”.
In December 2021 JDS Evans Pharmacy was successfully selected to enrol in “Greener Primary Care '' pilot scheme. This is a framework and award scheme in Wales that encourages all sectors of primary care to work towards becoming more sustainable in the practices and ultimately working towards becoming Net Carbon Zero.
The framework looked at all aspects of CO2 emissions and sustainability in the Pharmacy and this included 32 separate activities. Some examples included the installation of solar panels, encouraging staff to walk or cycle to work, making the change to an electric vehicle, installation of extra lagging in the loft (we chose a loft insulation material that is made from recycled plastic bottles).
As a result of these changes that we made in the Pharmacy, I was able to calculate my Carbon Footprint as 4 tonnes. I decided to offset this by electing to plant trees in Wales. In 2022 my Pharmacy became net carbon zero. As far as I am aware I am the first pharmacy in Wales to achieve this status (certificate attached)
The final section asked participants to look at an innovative project. I elected to look at the decarbonisation of inhalers. MDI inhalers contain the propellant HFA that is over 1000 times more potent than CO2 as a greenhouse gas. Furthermore, MDI inhalers are notoriously difficult to use without the use of a spacer, and even with perfect inhaler technique, only 50% of the dose will reach the lung.
The All Wales Adult Asthma Management and Prescribing Guidelines (see attached) now states that where possible a device should be chosen where it has a low carbon footprint. I wanted to devise a project that would demonstrate the difficulty of using an MDI to the patient, that would demonstrate the health advantages of changing to a DPI (in terms of increased lung deposition). I also wanted to explain the environmental consequences of using an MDI, and explain the benefits of converting to a DPI.
The project was devised as follows:-
• inviting patients for an inhaler review.
• take an asthma control test (ACT) to give a snapshot of their symptom control (act form attached)
• check their inhaler technique
• explain the carbon footprint of metered dose inhalers (MDI)
• give a demonstration of a low carbon footprint dry powder inhaler (DPI) and explain the health benefits of using a device that has improved lung deposition and the reduced carbon footprint of a DPI. • ask the patient whether they would be willing to change to the DPI.
• send a report into the respiratory nurse in the GP surgery who would update the repeat prescription as appropriate.
During the 2 month project, we saw 60 patients and 29 were converted from an MDI to a DPi. Only 1 patient refused to change. This represents a saving of 12 tons per year of Co2 emissions.
