Clearing the air: a systematic review on leadership challenges with sustainable inhaler prescribing

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dc.contributor.authorKajitani, Stenen
dc.contributor.authorGoodings, Anthony Jamesen
dc.contributor.authorRicha, Yasminaen
dc.contributor.authorBabun, Asis A.en
dc.contributor.authorChhor, Allisonen
dc.contributor.authorVelasco, Robertoen
dc.contributor.authorTrujillo, Juanen
dc.date.accessioned2025-09-05T15:37:33Z
dc.date.available2025-09-05T15:37:33Z
dc.date.issued2025-07-28en
dc.description.abstractBackground The environmental impact of inhalers, particularly pressurised metered dose inhalers with high global warming potential, poses significant challenges in the context of planetary health. Although dry powder inhalers (DPIs) offer a more sustainable alternative, entrenched prescribing practices prevail. This systematic review evaluates patient and physician perspectives on inhaler environmental impacts and examines barriers and opportunities for leadership in adopting sustainable practices. Methods Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a comprehensive literature search was performed from inception to 12 June 2024, across Medline via EBSCO, EMBASE via Elsevier and Web of Science. Four studies were included, surveying 433 participants. Data extraction and risk-of-bias assessment were conducted using a standardised form and the Newcastle-Ottawa Scale. Results Findings indicate that while both patients and providers express environmental concerns, limited awareness and entrenched clinical practices hamper the transition to DPIs. Leadership insights reveal that a fragmented sense of responsibility, insufficient training and low confidence in discussing environmental impacts are significant barriers. However, targeted education and interprofessional collaboration have been shown to increase the willingness to adopt sustainable inhaler practices. Conclusions The results underscore the need for leadership in healthcare to champion sustainable prescribing. Empowering clinicians through education, clear clinical guidelines and eco-ethical leadership initiatives is essential. Health leaders have the opportunity to transform practice by integrating environmental considerations into routine care, ultimately advancing planetary health.en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.articleid001257en
dc.identifier.citationKajitani, S., Goodings, A., Richa, Y., Babun, A.A., Chhor, A., Velasco, R. and Trujillo, J. (2025) 'Clearing the air: a systematic review on leadership challenges with sustainable inhaler prescribing,' BMJ Leader, 001257 (7pp). https://doi.org/10.1136/leader-2025-001257en
dc.identifier.doi10.1136/leader-2025-001257en
dc.identifier.eissn2398-631Xen
dc.identifier.endpage7en
dc.identifier.journaltitleBMJ Leaderen
dc.identifier.startpage1en
dc.identifier.urihttps://hdl.handle.net/10468/17830
dc.language.isoenen
dc.publisherBMJ Publishing Groupen
dc.rights© 2025, the Authors. Re-use permitted under CC BY- NC. No commercial re- use. See rights and permissions. Published by BMJ Group.en
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0/en
dc.subjectLeadership challengesen
dc.subjectSustainable inhaler prescribingen
dc.subjectComparisonen
dc.subjectOutcome frameworken
dc.subject~Medicine - Journal Articles~en
dc.titleClearing the air: a systematic review on leadership challenges with sustainable inhaler prescribingen
dc.typeArticle (peer-reviewed)en
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