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Beckett RS, Jagadish A, Carroll W, Gilchrist FJ. Quality improvement project assessing the feasibility of using canister weight to estimate remaining doses in a salbutamol pressurised metered-dose inhaler. Arch Dis Child 2024; 109:444-446. [PMID: 38316530 DOI: 10.1136/archdischild-2023-326678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/28/2024] [Indexed: 02/07/2024]
Affiliation(s)
- Robert S Beckett
- University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, ST4 6QG, UK
| | - Annapurna Jagadish
- University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, ST4 6QG, UK
| | - Will Carroll
- Paediatric Respiratory Medicine, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK
| | - Francis J Gilchrist
- Paediatric Respiratory Medicine, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK
- Institute of Applied Clinical Science, Keele University, Keele, UK
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2
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Connett G, Harper S, Raut B, James D. Hospital discharge using salbutamol as required after acute attacks of wheeze in children: a service evaluation. Arch Dis Child 2023; 109:2. [PMID: 37918898 PMCID: PMC10803954 DOI: 10.1136/archdischild-2023-325703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 09/17/2023] [Indexed: 11/04/2023]
Abstract
OBJECTIVE Most UK hospitals discharge children after acute wheeze with advice to give regular salbutamol using a fixed dose weaning regime. We have introduced and evaluated the safety and efficacy of changing practice to using bronchodilators only as needed after 4 hourly assessments. DESIGN A multidisciplinary team of healthcare professionals worked with eight families of children who had needed hospital treatment with acute wheeze to develop guidance for the use of salbutamol on an as required basis after 4 hourly assessments. Data on salbutamol used with this approach were compared with a similar period in the previous year. RESULTS Data from 103 families showed a 73% reduction in salbutamol on day 1, 69% on day 2 and 50% on day 3 compared with what would have been used according to previous advice. Families found the advice easy to follow. There was a trend towards lower reattendance rates within 1 week compared with those recorded in the previous year. Those who had previously attended preferred this change in practice. CONCLUSIONS These data suggest that with information to support the use of salbutamol on an as required basis after hospital attendance, children can be safely managed by their parents/guardians with much lower doses of salbutamol than those recommended in commonly used fixed dose weaning regimes.
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Affiliation(s)
- Gary Connett
- Paediatric Respiratory Medicine, University Hospital Southampton NHS Fundation Trust, Southampton, Hampshire, UK
| | - Stephanie Harper
- Paediatric Respiratory Medicine, University Hospital Southampton NHS Fundation Trust, Southampton, Hampshire, UK
| | - Bhargav Raut
- Paediatric Emergency Department, University Hospital Southampton NHS Foundation Trust, Southampton, Hampshire, UK
| | - David James
- Paediatric Emergency Department, University Hospital Southampton NHS Foundation Trust, Southampton, Hampshire, UK
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3
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Levy ML, Bateman ED, Allan K, Bacharier LB, Bonini M, Boulet LP, Bourdin A, Brightling C, Brusselle G, Buhl R, Chakaya MJ, Cruz AA, Drazen J, Ducharme FM, Duijts L, Fleming L, Inoue H, Ko FWS, Krishnan JA, Masekela R, Mortimer K, Pitrez P, Salvi S, Sheikh A, Reddel HK, Yorgancıoğlu A. Global access and patient safety in the transition to environmentally friendly respiratory inhalers: the Global Initiative for Asthma perspective. Lancet 2023; 402:1012-1016. [PMID: 37480934 DOI: 10.1016/s0140-6736(23)01358-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 06/12/2023] [Accepted: 06/27/2023] [Indexed: 07/24/2023]
Affiliation(s)
| | - Eric D Bateman
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Keith Allan
- Department of Patient and Community Engagement, University Hospitals of Leicester, Leicester, UK
| | - Leonard B Bacharier
- Department of Pediatrics, Monroe Carell Jr Children's Hospital at Vanderbilt University Medical Center, Nashville, TN, USA
| | - Matteo Bonini
- Department of Cardiovascular and Pulmonary Sciences, Università Cattolica del Sacro Cuore, Fondazione Policlinico A Gemelli-IRCCS, Rome, Italy
| | | | - Arnaud Bourdin
- Department of Respiratory Diseases, University of Montpellier, Montpellier, France
| | - Chris Brightling
- Institute for Lung Health, Leicester NIHR BRC, University of Leicester, Leicester, UK
| | - Guy Brusselle
- Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium; Departments of Epidemiology and Respiratory Medicine, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Roland Buhl
- Pulmonary Department, Mainz University Hospital, Mainz, Germany
| | | | - Alvaro A Cruz
- ProAR Foundation and School of Medicine, Federal University of Bahia, Salvador, Brazil
| | - Jeffrey Drazen
- Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Francine M Ducharme
- Departments of Pediatrics and of Social and Preventive Medicine, Sainte-Justine University Health Centre, University of Montreal, Montreal, QC, Canada
| | - Liesbeth Duijts
- Department of Pediatrics, Divisions of Respiratory Medicine and Allergology and Neonatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Louise Fleming
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Hiromasa Inoue
- Department of Pulmonary Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Fanny W S Ko
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Jerry A Krishnan
- Breathe Chicago Center, University of Illinois Chicago, Chicago, IL, USA
| | - Refiloe Masekela
- Department of Paediatrics and Child Health, University of KwaZulu Natal, Durban, South Africa
| | - Kevin Mortimer
- Department of Paediatrics and Child Health, University of KwaZulu Natal, Durban, South Africa; Department of Respiratory Medicine, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK; Cambridge Africa Department, University of Cambridge, Cambridge, UK
| | - Paulo Pitrez
- Pulmonology Department, Hospital Santa Casa de Porto Alegre, Porto Alegre, Brazil
| | - Sundeep Salvi
- Pulmocare Research and Education (PURE) Foundation, Pune, India
| | - Aziz Sheikh
- Primary Care Research & Development and Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Helen K Reddel
- Woolcock Institute of Medical Research and The University of Sydney, Sydney, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Urrutia-Pereira M, Chong-Neto HJ, Winders TA, Solé D. Environmental impact of inhaler devices on respiratory care: a narrative review. J Bras Pneumol 2023; 48:e20220270. [PMID: 36651436 PMCID: PMC9747156 DOI: 10.36416/1806-3756/e20220270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 11/07/2022] [Indexed: 11/16/2022] Open
Abstract
Climate change is a huge and present threat to human health. This article aims to deepen the knowledge about the environmental impact of inhaler devices on their carbon footprint for patients and health professionals, providing information that allows a better choice of the type of device to be prescribed for the treatment of asthma and COPD. This narrative and nonsystematic review was carried out by searching databases (PubMed, Google Scholar, SciELO, and EMBASE) for articles published between 2017 and 2022, written in Portuguese or in English, using the search words "inhalation device" OR "environmental." The review showed that global warming cannot be addressed by focusing only on inhaler devices. However, the devices that we use to treat respiratory diseases such as asthma and COPD, which are diseases that are aggravated by climate change, are also causing that change. Therefore, health professionals, patient organizations, and industries should take a lead in health policies to offer affordable alternatives to inhalers containing hydrofluoroalkane.
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Affiliation(s)
| | | | - Tonya A Winders
- . Global Allergy and Airways Patient Platform, Vienna, Austria
| | - Dirceu Solé
- . Departamento de Pediatria, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo (SP) Brasil
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Pourchez J, Mercier C, Forest V. From smoking to vaping: a new environmental threat? THE LANCET. RESPIRATORY MEDICINE 2022; 10:e63-e64. [PMID: 35617988 DOI: 10.1016/s2213-2600(22)00187-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 05/06/2022] [Accepted: 05/06/2022] [Indexed: 06/15/2023]
Affiliation(s)
- Jérémie Pourchez
- École Nationale Supérieure des Mines de Saint-Etienne, Université de Lyon, Université Jean Monnet, and Établissement Français du Sang, INSERM U1059, Sainbiose, 42023 Saint-Etienne CEDEX 2, France.
| | - Clément Mercier
- École Nationale Supérieure des Mines de Saint-Etienne, Université de Lyon, Université Jean Monnet, and Établissement Français du Sang, INSERM U1059, Sainbiose, 42023 Saint-Etienne CEDEX 2, France
| | - Valérie Forest
- École Nationale Supérieure des Mines de Saint-Etienne, Université de Lyon, Université Jean Monnet, and Établissement Français du Sang, INSERM U1059, Sainbiose, 42023 Saint-Etienne CEDEX 2, France
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