ArticleNPJ primary care respiratory medicine2025
Resultant greenhouse gases from the use of inhaled corticosteroid based on Global Initiative for Asthma (GINA) guidelines: a primary care used case from Singapore.
Article in NPJ primary care respiratory medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
2 citing papers in PubMed.
- Article
- Comparing 6-Year Carbon Footprint Between GINA Track 1 and 2 Asthma Management for Adults: A Real-World Primary Care Report from Singapore to Advocate for Policy Change in Inhaler Procurement.Journal of primary care & community healthArticle
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Inhaled corticosteroid (ICS) is recommended by Global Initiative for Asthma 2022 Guidelines for patients to attain asthma control. However, inhalational short-acting β2-agonist (SABA) is needed for reliever therapy and emits greenhouse gases (GHG). Despite evidence supporting ICS-formoterol's superior effectiveness as both maintenance and reliever therapy, and more recent guidelines as the preferred treatment option, some patients continue to be prescribed with ICS. The study aimed to quantify GHG from adults on ICS inhalers treated in primary care in Singapore, including their SABA use, and compare good versus suboptimal asthma control. Data from nine public primary care clinics in eastern Singapore were retrieved from the electronic medical records, comprising asthma-diagnosed patients aged 21 years and older. Records contained their demography, clinical diagnoses, asthma control test (ACT) scores and ICS (beclomethasone pMDI, budesonide DPI and fluticasone pMDI) dispensed from in-house pharmacies. Patients with ACT ≥ 20 were classified as having good asthma control. Total GHG resulting from ICS and SABA were calculated for pMDI or DPI inhalers. Between 2015 and 2023, patients on ICS decreased from 3647-2265, while proportion of well-controlled asthma improved from 53.6-82.5%. Annual GHG emissions showed substantial reductions: ICS-only emissions fell from 101,685-71,899 kgCO
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