Analysis of UK inhaler medicine use and carbon footprint presented at the British Thoracic Society Winter Meeting

AstraZeneca, UK, Luton: 17 February 2021: New analysis of respiratory inhaler medicine use in the UK shows that 83% of all short-acting beta-2-agonist (SABA) relievers for asthma are prescribed to patients who are potentially overusing their reliever medication (prescribed ≥3 inhalers/year).¹ The overuse of SABA relievers represents 9.24 million SABA prescriptions and is responsible for 250,000 tonnes of CO₂ equivalent annually.¹

The prescription of three or more SABA asthma inhalers per year is associated with poor asthma control and approximately twice the number of attacks

These findings will be presented at the British Thoracic Society Winter Meeting and are based on SABA prescription and use data extracted from the UK study in the SABA Use IN Asthma (SABINA) global programme of harmonised, large-scale observational studies collected between 2007-2017.²

The prescription of three or more SABA inhalers per year is associated with poor asthma control, approximately twice the number of exacerbations compared with low SABA users (prescribed 0-2 inhalers/year) and increased asthma-related healthcare utilisation.^2,3 Asthma is a chronic, variable, inflammatory disease affecting 5.4 million people in the UK (4.3 million adults) and can cause asthma attacks and symptoms including breathlessness and wheezing.^4,5 Every 10 seconds someone in the UK has a potentially life-threatening asthma attack with, on average, three people dying from asthma every day.⁵

Alexander J K Wilkinson, Consultant in Respiratory and General Medicine, East and North Hertfordshire NHS Trust, Stevenage, UK and lead author of the study said: “Overuse of reliever inhalers in asthma is widespread in the UK and associated with an increased risk of exacerbations for patients, highlighting the importance of adopting strategies to improve disease control and reduce short-acting beta-2-agonist overuse. This new analysis shows that reliever overuse is also a major contributor to greenhouse gas emissions in respiratory care, similar to driving an average diesel car for about 900 million miles. These findings are important for informing clinical guidelines and healthcare policies to support improvements in asthma care while also realising carbon savings.”

Alex de Giorgio-Miller, Vice President, Medical & Scientific Affairs, AstraZeneca UK, said: “We know that the overuse of SABA ‘reliever’ inhalers is associated with an increased risk of severe asthma attacks, but this analysis highlights the scale of the problem we face in the UK, both in terms of poor health outcomes and the corresponding greenhouse gas burden. By reducing over-reliance on SABA inhalers and improving asthma outcomes, we can also have an important positive impact on the environment.”

Further results from the analysis showed that SABA inhaler use drives 70% of greenhouse gas emissions (GHG) from inhaler devices in the UK.¹ The per capita use of all SABA reliever inhalers in the UK was approximately treble or more than that observed in other large European countries, resulting in even higher GHG emissions.

Months after becoming the first country in the world to test its entire population, Slovakia now has the highest coronavirus death rate in the world.

The nation currently has the highest seven-day rolling average of COVID deaths per 1 million people in its population compared with any other country.

As of 15 February, there were 17.82 new coronavirus deaths per 1 million people, according to Our World in Data.

This was followed by Portugal with 14.81, Montenegro with 12.63, San Marino with 12.63 and Czechia with 12.23.

Read: The underlying health conditions that allow people to get a vaccine sooner

The UK, which has seen more than 117,000 deaths since the pandemic began, came in sixth with 9.70 deaths per million as of 15 February.

It comes after Slovakia tested its entire population in October as part of a scheme that was widely praised and was understood to have brought down infections.

Cases in the country were reduced by more than 60% in one week, according to a preliminary analysis by the London School of Hygiene & Tropical Medicine.

However, just months later, Slovakia's rate of new COVID deaths are the highest in the world. So what went wrong?

What went wrong in Slovakia?

Slovakia has fared much worse during the second wave of coronavirus compared to the first, with cases skyrocketing since October.

Between the start of the pandemic in early 2020 and August that year, the rate of new infections in Slovakia did not rise above 10.96 per million people, according to Our World In Data.

Meanwhile, other European countries like the UK, Spain, Italy and France were seeing hundreds of people dying from the disease every day, especially during the peak around April.

Cases steadily began to rise in Slovakia from August before a sharp drop at the beginning of November, just after the entire nation was tested.

Watch: Slovakia starts testing entire population after surge in COVID-19 cases 

 

Scroll back up to restore default view.

Just before Christmas, Slovakia entered a tough national lockdown that included a round-the-clock curfew in a bid to curb the spread.

Case numbers peaked on 6 January at 597.08 cases per million people, and although they have since fallen, the figures are far off the low rates seen during the first wave.

The Slovakian government has blamed the UK variant of the virus for the recent rise in cases and deaths.

Earlier this month, it announced the fast-spreading strain had become dominant.

Health authorities reportedly sequenced all samples that tested positive in the country in a single day and found the British variant was detected in 74%. Health minister Mark Krajci called this an “unbelievable high number”, according to AP.

What's going on in Eastern Europe?

Like Slovakia, the majority of Eastern Europe was praised for its handling of the first wave after most countries locked down early and citizens appeared to stick to the harsh rules.

But the whole region’s pandemic experience has been dramatically different since the autumn, when cases and deaths began to rise across the board.

This week, Slovakia was not the only Eastern European country in the top five for the highest death rates in the world – Montenegro and Czechia have the third and fifth highest rate respectively.

Meanwhile, on Friday, total COVID cases in Russia, Poland, Czechia, Romania, Hungary, Slovakia and Bulgaria together surpassed 10 million and total COVID deaths in the region topped 214,000 deaths, according to Reuters tally.

Several of the countries are also dealing with huge anti-vaccination movements, which are threatening their path to recovery.

Vaccine sceptics in countries like the Czechia, Serbia, Bosnia, Romania and Bulgaria have included former presidents and doctors. Even Serbian tennis star Novak Djokovic said he did not want to be forced into getting a vaccine.

The hesitancy comes on the back of conspiracy theories like claims that coronavirus is a hoax or that vaccines are being used to inject microchips into people.

According to the AP, a recent Balkan study warned there is a direct link between support for conspiracy theories and scepticism toward vaccination.

“A majority across the region does not plan to take the vaccine, a ratio considerably lower than elsewhere in Europe, where a majority favours taking the vaccine,” it reportedly said.

Elsewhere, Germany has recently ramped up border controls with Czechia and Austria’s Tyrol region amid fears over outbreaks of COVID variants strains.

Read more:

First travellers fined £10,000 under new COVID travel quarantine rules

What you can and can't do under current lockdown rules

The country has recently seen a drop in daily infection rates but the spread of new variants in neighbouring countries, like France, threaten to undo those gains, Reuters reported.

One explanation for why Eastern Europe fared much better in the first wave than the rest of the continent is that countries locked down fast when infection numbers were still low, according to The Conversation.

The publication’s analysis showed the region then failed to introduce stringent measures when cases first began to soar in October. Yahoo  News