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 (2008‒2019) were included. GHG emissions, measured as carbon dioxide equivalent (CO2e), 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 β2-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 CO2e/year, with poorly controlled asthma contributing excess GHG emissions of 303 874 tonnes CO2e/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. Data are available on reasonable request. Data underlying the findings described in this manuscript may be obtained in accordance with AstraZeneca’s data sharing policy described at . Data for studies directly listed on Vivli can be requested through Vivli at [https://www.vivli.org/][1]. Data for studies not listed on Vivli could be requested through Vivli at . AstraZeneca Vivli member page is also available outlining further details: . [1]: https://vivli.org/

中文翻译：

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英国温室气体排放与次优哮喘护理相关：基于 SABINA healthCare 的环境治疗成本 (CARBON) 研究

背景 哮喘控制不佳与发病率和医疗资源利用率 (HCRU) 增加相关。因此，为了量化哮喘护理对环境的影响，这项基于 healthCARe 的回顾性队列环境治疗成本 (CARBON) 研究估计了英国与控制良好和控制不良的哮喘管理相关的温室气体 (GHG) 排放量。方法纳入在临床实践研究数据链（2008-2019）注册的当前哮喘患者（年龄≥12岁）。以二氧化碳当量 (CO2e) 测量的温室气体排放量，针对基线时被分类为控制良好的哮喘患者（<3 短效 β2 激动剂 (SABA)）的随访期间与哮喘相关的药物使用、HCRU 和恶化情况进行估计）罐/年且无恶化）或控制不佳（≥3 个 SABA 罐/年或≥1 次恶化）。因哮喘控制不佳而导致的过量温室气体排放包括每年 ≥3 个 SABA 罐处方、病情加重以及住院或急诊科就诊 10 天内的任何全科医生和门诊就诊。结果 在分析的 236 506 名患者中，47.3% 的基线哮喘控制不佳。从国家层面来看，英国哮喘护理的总体碳足迹为 750 540 吨 CO2e/年，哮喘控制不佳导致每年超额温室气体排放 303 874 吨 CO2e，相当于超过 124 000 栋房屋的排放量在英国。与控制良好的哮喘相比，控制不佳的哮喘产生的总体碳足迹高出 3.1 倍，人均碳足迹高出 8.1 倍，这主要是 SABA 引起的，HCRU 的贡献较小。结论 这些研究结果表明，解决哮喘控制不佳的高负担，包括抑制 SABA 的高使用及其相关的病情加重风险，可能会显着减轻与哮喘护理相关的碳排放。可根据合理要求提供数据。本手稿中描述的研究结果背后的数据可以根据阿斯利康的数据共享政策获得，该政策描述于。 Vivli 上直接列出的研究数据可以通过 Vivli 索取：[https://www.vivli.org/][1]。 Vivli 上未列出的研究数据可通过 Vivli 索取：。还提供 AstraZeneca Vivli 会员页面，其中概述了更多详细信息：。 [1]：https://vivli.org/