Greenhouse gas emissions associated with COPD care in the UK: results from SHERLOCK CARBON

Clinical Research Results Abstract Introduction: Exacerbation history is linked with an increased likelihood and rate of future exacerbations in patients with chronic obstructive pulmonary disease (COPD). The environmental implications of this association have not been quantified. This study aimed to describe the impact of exacerbation history on greenhouse gas (GHG) emissions for healthcare resource utilisation (HCRU) and short-acting β2-agonist (SABA) use in COPD, as part of the healthCARe-Based carbON cost of treatment (CARBON) programme using data from SHERLOCK.Methods: SHERLOCK was a retrospective cohort study (2013–2016) of 22,462 patients with COPD in the United Kingdom (UK), categorised by exacerbation exposure.1 GHG emissions (CO2 equivalent, CO2e) linked with SABA prescribing and HCRU were estimated for 3-years of follow-up.2 The contribution of preventer inhaler prescribing to GHG emissions per patient on an annual basis was estimated using Longitudinal Patient Data obtained from IQVIA™ for patients who received a prescription for respiratory medicine and had COPD in their medical record.3Results: A history of severe or multiple COPD exacerbations increased the carbon footprint of future COPD-related HCRU and SABA prescribing by 50% for each year of follow-up (Table 1). The average GHG emissions for preventer use were estimated to be 50.3 kg CO2e per patient per year.Discussion: COPD exacerbation history is associated with an increase in future GHG emissions from healthcare. The estimated GHG emissions from preventer inhaler use suggest that these medicines may make a smaller relative contribution to the overall carbon footprint of healthcare versus variable factors, such as COPD-related or all-cause HCRU and SABA prescribing. The totality of care and patient status are important factors when considering the GHG emissions associated with COPD healthcare. Research Idea Abstract Service Development & Evaluation Abstract Declaration of Interest The study was designed and funded by AstraZeneca. References and Clinical Trial Registry Information Bell J., et al. Eur Respir J 56 (suppl 65): PA3551 (2021). https://doi.org/10.1183/13993003.congress-2021.PA3551Sustainable Healthcare Coalition. Care Pathway Carbon Calculator. https://shcoalition.org/care-pathway-carbon-calculator-2LPD, IQVIA Ltd, incorporating data derived from THIN, A Cegedim Database, Jun-21. https://www.iqvia.com/-/media/iqvia/pdfs/uk/fact-sheets/iqvia-longitudinal-patient-data.pdf