CO2e emission savings with non-clinically driven DPI use within the SITT class are offset by increased emissions from poorer clinical control and healthcare use. Prescribing policies/guidelines preferring DPIs over pMDIs for environmental reasons should be updated, recognizing that pMDIs with NGP have a greenhouse gas footprint similar to DPIs. Optimal COPD management through evidence-based guidelines and appropriate inhaler selection is crucial to minimizing carbon footprint and healthcare resource utilization while improving patient outcomes.
Parsekar et al. (2026) studied this question.
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