Interventions Resources

An awareness of the impact of climate change has led to policies to reduce greenhouse gas emissions (GHGEs). The National Health Service (NHS) is the UK public sector’s largest emitter of greenhouse gases, with a target to deliver a net zero NHS by 2050 (NHS, 2020). Pressurised metered dose inhalers (pMDIs), which use hydrofluoroalkanes (HFA) as the propellant, have been targeted as a perceived easy option to reduce the NHS carbon footprint of HFA, as alternative inhaler devices in the form of dry powder inhalers (DPIs) and soft mist inhalers (SMIs) which contain no propellant are readily available. Balancing the environmental impact while ensuring that the best option of inhaler device is provided for individual patients can lead to conflict and confusion for healthcare professionals while waiting for manufacturers to provide pMDI with propellants that are more environmentally friendly. This article discusses sustainability, from manufacture to disposal.

For many nurses working in general practice, chronic obstructive pulmonary disease (COPD) is a familiar condition. From carrying out annual reviews to supporting people living with the symptoms of cough, phlegm, breathlessness and managing their effect on day-to-day living, most general practice nurses (GPNs) will have some experience of supporting people living with COPD. Increasingly, though, GPNs are having to consider comorbidities as part of the review, as for many people living with COPD, this will be just one of the long-term conditions they have already been diagnosed with or of which they will be at risk. In this article, the relationship between COPD and other long-term conditions will be highlighted, along with recommendations about how to identify and manage comorbidities in order to holistically optimise outcomes.