Section 8.6 of the new BTS/SIGN Guideline for the management of asthma highlights the environmental impact of metered dose inhalers (pMDI) and recommends that inhalers with low global-warming potential (GWP) should be used when likely to be equally effective.
Are you confident in teaching patients how to use their inhalers? The first step in improving environmental sustainability of inhaler use is to ensure that people use the correct technique to get the drug to where it is needed.
This example driver diagram shows how principles of sustainable clinical practice can be applied to improve respiratory inhaler prescribing. Hopefully it shows a holistic approach (MDI>DPI is not the whole story...).