| アブストラクト | BACKGROUND: Poorly controlled asthma is associated with increased morbidity and healthcare resource utilisation (HCRU). Therefore, to quantify the environmental impact of asthma care, this retrospective, cohort, healthCARe-Based envirONmental cost of treatment (CARBON) study estimated greenhouse gas (GHG) emissions in the UK associated with the management of well-controlled versus poorly controlled asthma. METHODS: Patients with current asthma (aged >/=12 years) registered with the Clinical Practice Research Datalink (2008 E019) were included. GHG emissions, measured as carbon dioxide equivalent (CO(2)e), were estimated for asthma-related medication use, HCRU and exacerbations during follow-up of patients with asthma classified at baseline as well-controlled (<3 short-acting beta(2)-agonist (SABA) canisters/year and no exacerbations) or poorly controlled (>/=3 SABA canisters/year or >/=1 exacerbation). Excess GHG emissions due to suboptimal asthma control included >/=3 SABA canister prescriptions/year, exacerbations and any general practitioner and outpatient visits within 10 days of hospitalisation or an emergency department visit. RESULTS: Of the 236 506 patients analysed, 47.3% had poorly controlled asthma at baseline. Scaled to the national level, the overall carbon footprint of asthma care in the UK was 750 540 tonnes CO(2)e/year, with poorly controlled asthma contributing excess GHG emissions of 303 874 tonnes CO(2)e/year, which is equivalent to emissions from >124 000 houses in the UK. Poorly controlled versus well-controlled asthma generated 3.1-fold higher overall and 8.1-fold higher excess per capita carbon footprint, largely SABA-induced, with smaller contributions from HCRU. CONCLUSIONS: These findings suggest that addressing the high burden of poorly controlled asthma, including curbing high SABA use and its associated risk of exacerbations, may significantly alleviate asthma care-related carbon emissions. |
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| ジャーナル名 | Thorax |
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| 投稿日 | 2024/2/28 |
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| 投稿者 | Wilkinson, Alexander J K; Maslova, Ekaterina; Janson, Christer; Radhakrishnan, Vasanth; Quint, Jennifer K; Budgen, Nigel; Tran, Trung N; Xu, Yang; Menzies-Gow, Andrew; Bell, John P |
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| 組織名 | Department of Respiratory Medicine, East and North Hertfordshire NHS Trust,;Stevenage, UK.;BioPharmaceuticals Medical, AstraZeneca UK Ltd, Cambridge, UK.;Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala;University, Uppsala, Sweden.;ZS Associates, Bengaluru, India.;National Heart Lung Institute, Imperial College London, London, UK.;Global Sustainability, AstraZeneca, Macclesfield, UK.;BioPharmaceuticals Medical, AstraZeneca, Gaithersburg, Maryland, USA.;BioPharmaceuticals Medical, AstraZeneca Switzerland, Baar, Switzerland;john.bell2@astrazeneca.com. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/38413192/ |
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