Presenter of 3 Presentations
ENVIRONMENTALLY SUSTAINABLE FAMILY PRACTICE AND THE PLANETARY HEALTH MOVEMENT IN THE WONCA EUROPE REGION - SPEAKERS
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AUDIT OF THE CARBON FOOTPRINT OF INHALERS IN AN IRISH GENERAL PRACTICE
Abstract
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Background and purpose: Respiratory disease is common and mostly managed in primary care. The most frequently employed therapeutics are inhalers which vary in type. Multidose Inhalers (MDIs) contain harmful greenhouse gases which have a disproportionate effect on the carbon footprint of healthcare. The NHS estimates inhalers account for 3% of their entire carbon footprint and have identified inhaler prescribing as a target to achieve “net zero” by 2040. The carbon footprint of inhalers prescribed in Irish General Practice is not known nor is the potential carbon savings by switching to more environmentally friendly alternatives such as dry powder inhalers (DPIs).
Methods: The carbon equivalent of prescribed inhalers in a mixed rural urban GP practice was determined retrospectively January – June 2020. An educational team intervention was performed aiming to switch MDIs to DPIs where appropriate, with patient counselling and consent and in line with best practice. Inhaler prescribing was re-audited July -December 2020 and the carbon equivalent difference estimated.
Results: At baseline the practice prescribed 84% MDIs to 16% DPIs. After the intervention this was reduced to 70% MDIs to 30% DPIs. The carbon equivalent difference was 3,575 kgC02 per month. Over the six months of the duration of the audit this equated to saving approximately 21, 448 kg of CO2.
Conclusions: Targeting inhaler prescribing offers the potential to significantly improve the carbon footprint of Irish healthcare. The carbon saved in this audit was the equivalent of driving around the globe twice or charging almost 3 million smart phones. DPIs may also improve compliance, improve drug delivery and reduce waste.
ATTITUDES ON THE ROLE OF NUTRITION IN PRIMARY CARE: GP TRAINEE AND PROGRAMME DIRECTOR SURVEY
Abstract
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Background and purpose: Nutrition is the leading cause of chronic disease globally, yet the nutritional component of medical education remains insufficient. In the context of Irish General Practice it is unknown how much nutritional education GP trainees receive and how well equipped they feel to manage the nutritional aspect of chronic disease. The purpose was to identify GP trainee attitudes to the nutritional component of chronic disease in GP training and to compare with the programme directors who deliver this training.
Methods: A multicentre online survey questionnaire of 542 GP trainees in Ireland and 63 GP training scheme programme directors.All 14 Irish GP training schemes in Ireland were invited to have their trainees and programme directors answer an online survey over a 2 week period in September 2019.
Results: 93 trainees (16%) and 9 programme directors (14%) answered. There was consensus and agreement for the following; it is the role of the GP to promote a healthy diet; there are barriers to providing optimal nutritional management; and there would be interest in further training. Barriers identified included a lack of access to dietitians and inadequate education. ANOVA analysis found that there was agreement in the assertion that nutritional education to date is not adequate.
Conclusions: There is agreement between GP trainees and their programme directors that the nutritional educational component of GP training is currently an unmet need. This study highlights the need for an improvement in nutritional education to maximise the management of chronic disease in Irish general practice.