{"id":6564,"date":"2023-12-12T14:13:46","date_gmt":"2023-12-12T13:13:46","guid":{"rendered":"https:\/\/choosingwiselyitaly.org\/?post_type=raccomandazione-prof&p=6564"},"modified":"2025-04-17T15:58:18","modified_gmt":"2025-04-17T13:58:18","slug":"do-not-routinely-prescribe-metered-dose-inhalers-but-dry-powder-inhaler","status":"publish","type":"raccomandazione-prof","link":"https:\/\/choosingwiselyitaly.org\/en\/raccomandazione-prof\/do-not-routinely-prescribe-metered-dose-inhalers-but-dry-powder-inhaler\/","title":{"rendered":"Do not routinely prescribe metered-dose inhalers but dry powder inhalers."},"content":{"rendered":"

Asthma and Chronic Obstructive Pulmonary Disease (COPD) have therapeutic benefits from inhalation medications, available in two pharmaceutical formulations: metered-dose inhalers and dry powder inhalers. Consequently, the prescription preference should be directed towards the latter for three distinct reasons:
\n\u2022 Ease of Administration: dry powder inhalers obviate the necessity for spacers or specific maneuvers, thus affording simplified utilization.
\n\u2022 Efficacy: powder formulations exhibit enhanced penetration into the distal airways compared to aerosol sprays, thereby optimizing therapeutic impact.
\n\u2022 Environmental Sustainability: aerosol inhalers employ hydrofluorocarbon propellants, potent greenhouse gases, thereby bearing a carbon footprint over 40 times higher than that of dry powder inhalers. This environmental burden is so substantial that it is estimated to account for 4% of the entire healthcare sector’s carbon emissions in the United Kingdom.
\nHowever, the choice must be shared with the patients and based on individual benefits and risks, also according to age and general conditions.<\/p>\n","protected":false},"featured_media":2380,"template":"","meta":{"_wpv_contains_gutenberg_views":[""],"_layouts_template":["modello-per-raccomandazioni-professionista"],"_wp_page_template":["default"],"_wpml_word_count":["{\"total\":303,\"to_translate\":{\"it\":303}}"],"_edit_lock":["1744898275:2"],"_edit_last":["2"],"_wpml_media_featured":["1"],"_wpml_media_duplicate":["1"],"_wpml_location_migration_done":["1"],"cmplz_hide_cookiebanner":[""],"_yoast_wpseo_primary_eta":["96"],"_yoast_wpseo_primary_disciplina":["127"],"_yoast_wpseo_primary_tipologia":["99"],"wpcf-pacchetto":["ISDE #2"],"wpcf-bibliografia":["1. Kerwin EM et al. ELLIPTA dry powder versus metered-dose inhalers in an optimized clinical trial setting. J Allergy Clin Immunol Pract. 2019;7:1843-49.\r\n2. Wilkinson A, et al. The environmental impact of inhalers for asthma: a green challenge and a golden opportunity. Br J Clin Pharmacol. 2022;88:3016-22.\r\n3. Fidler L et al Pressurized metered-dose inhalers and their impact on climate change. CMAJ 2022;194:E460. \r\n4. How to Reduce the Carbon Footprint of Inhaler Prescribing. A Guide for Healthcare Professionals in the UK https:\/\/www.greenerpractice.co.uk\/high-quality-and-low-carbon-asthma-care\/resources\/Environmental stewardship of pressurised metered-dose inhalers - https:\/\/codachange.org\/mdi-info\r\n5. Born KB, Levinson W, Vaux E Choosing Wisely and the climate crisis: a role for clinicians BMJ Quality & Safety Published Online First: 02 June 2023"],"wpcf-posizione-prof":["4"],"wpcf-collegare":["N"],"wpcf-link-intercheck-prof":["N"],"wpcf-parole-chiave-prof":[""],"wpcf-pdfpdf-prosfessionista":["https:\/\/choosingwiselyitaly.org\/wp-content\/uploads\/2023\/09\/Scheda-ISDE-MMG-green-english-3-corretta.pdf"],"wpcf-area-ordinamento":["General Practice and Primary Care"],"_yoast_wpseo_content_score":["60"],"_yoast_wpseo_focuskeywords":["[]"],"_yoast_wpseo_keywordsynonyms":["[\"\"]"],"_cmplz_scanned_post":["1"],"_wp_old_date":["2023-09-05"],"_thumbnail_id":["2380"],"_et_dynamic_cached_shortcodes":["a:4:{i:0;s:13:\"et_pb_section\";i:1;s:9:\"et_pb_row\";i:2;s:12:\"et_pb_column\";i:50;s:10:\"et_pb_text\";}"],"_et_dynamic_cached_attributes":["a:0:{}"],"et_enqueued_post_fonts":["a:3:{s:6:\"family\";a:1:{s:15:\"et-gf-work-sans\";s:136:\"Work+Sans:100,200,300,regular,500,600,700,800,900,100italic,200italic,300italic,italic,500italic,600italic,700italic,800italic,900italic\";}s:6:\"subset\";a:2:{i:0;s:5:\"latin\";i:1;s:9:\"latin-ext\";}s:9:\"cache_key\";s:75:\"{\"gph\":-1,\"divi\":\"4.27.6\",\"wp\":\"6.9.4\",\"enable_all_character_sets\":\"false\"}\";}"]},"eta":[{"term_id":96,"name":"Adult","slug":"adult","term_group":0,"term_taxonomy_id":96,"taxonomy":"eta","description":"","parent":0,"count":272,"filter":"raw"},{"term_id":97,"name":"Geriatric","slug":"geriatric","term_group":0,"term_taxonomy_id":97,"taxonomy":"eta","description":"","parent":0,"count":242,"filter":"raw"}],"disciplina":[127],"tipologia":"Drugs","class_list":["post-6564","raccomandazione-prof","type-raccomandazione-prof","status-publish","has-post-thumbnail","hentry","eta-adult","eta-geriatric","disciplina-general-practice-and-primary-care","tipologia-drugs"],"_links":{"self":[{"href":"https:\/\/choosingwiselyitaly.org\/en\/wp-json\/wp\/v2\/raccomandazione-prof\/6564","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/choosingwiselyitaly.org\/en\/wp-json\/wp\/v2\/raccomandazione-prof"}],"about":[{"href":"https:\/\/choosingwiselyitaly.org\/en\/wp-json\/wp\/v2\/types\/raccomandazione-prof"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/choosingwiselyitaly.org\/en\/wp-json\/wp\/v2\/media\/2380"}],"wp:attachment":[{"href":"https:\/\/choosingwiselyitaly.org\/en\/wp-json\/wp\/v2\/media?parent=6564"}],"wp:term":[{"taxonomy":"eta","embeddable":true,"href":"https:\/\/choosingwiselyitaly.org\/en\/wp-json\/wp\/v2\/eta?post=6564"},{"taxonomy":"disciplina","embeddable":true,"href":"https:\/\/choosingwiselyitaly.org\/en\/wp-json\/wp\/v2\/disciplina?post=6564"},{"taxonomy":"tipologia","embeddable":true,"href":"https:\/\/choosingwiselyitaly.org\/en\/wp-json\/wp\/v2\/tipologia?post=6564"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}