RandomisED Control Trial to Understand Whether Prescribing Choice for inhalErs is Influenced by Knowledge of the CARBON Footprint (REDUCE Carbon)

Climate change is a huge and present threat, with the devastating effects being increasingly seen in everyday life. The NHS contributes substantially to the UKs carbon footprint with an estimated 23 million tonnes gCO2Eq per year, 3% of which comes from pMDIs. There are a number of alternative inhalers, such as DPIs, which do not use propellant and therefore have a significantly lower carbon footprint. There is a call to move towards greener inhalers as part of the NHS long term plan for sustainability, to reduce the carbon footprint and therefore the environmental impact and help protect the health of our patients today and in the future. When recommending an inhaler, a number of factors are usually considered including the ability of the patient to use the device and its cost. Up until now the environmental impact of each inhaler is not routinely available and therefore is not normally considered in prescription choice. Given the increasing evidence supporting the sizeable impact that pMDIs are having on global warming, there needs to be a shift in practice where the climate impact forms part of the decision-making process. This study is looking to explore prescribing behaviours surrounding inhaler selection and in particular whether knowledge of the carbon footprint of inhalers has any sway on prescribing preference. By better understanding the decision-making process, this will allow the production of more comprehensive asthma management guidelines and potentially facilitate a drive to greener inhaler prescribing practices.

Inclusion Criteria: * Aged ≥18 years * Working as an HCP within the NHS in a primary or secondary care setting * Able to provide written e-consent * Able to understand and complete the clinical case scenarios Exclusion Criteria: * Inability to understand or comply with study procedures and/or inability to give fully informed consent.