{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T05:13:06Z","timestamp":1771477986622,"version":"3.50.1"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T00:00:00Z","timestamp":1757635200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The environmental impact of asthma is multifactorial and personalized strategies to optimize treatment and achieve improved asthma control are required to reduce asthma related carbon emissions. Digital interventions, such as electronic monitoring devices (EMDs) could be one potential solution to support inhaler optimization. This article explores the clinical and sustainability benefits of EMDs and the impact they could have on decarbonizing the asthma pathway.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An electronic database search was carried out on PubMed, Ovid Embase, Ovid Medline, and the Cochrane library, in November 2024 and updated in April 2025. A structured search was used including free text and MeSH terms using the key terms \u2018asthma\u2019, \u2018adherence\u2019, and terms related to \u2018digital inhaler\u2019, \u2018digital sensor\u2019, \u2018electronic monitoring device\u2019, and \u2018environmental sustainability\u2019. Fully published randomized controlled trials, systematic reviews or meta-analyses, and cohort studies were retrieved. Search results were limited to adolescent and adult asthma patients. Articles not published in English language were excluded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key findings<\/jats:title>\n                    <jats:p>The review identifies that EMDs, particularly when combined with education and feedback, have the potential to reduce the carbon impact of asthma through improved adherence to preventer inhalers, reduced reliever overuse, and improved asthma control. However, the current evidence is limited and larger comparative studies demonstrating their impact on clinical outcomes and health economic and environmental factors are required.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Digital inhaler monitors could potentially support treatment optimization and decarbonization of the asthma pathway. Further research is required to truly understand their potential and support their adoption into clinical practice in the UK.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ijpp\/riaf073","type":"journal-article","created":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T11:22:11Z","timestamp":1756120931000},"page":"94-98","source":"Crossref","is-referenced-by-count":1,"title":["Decarbonization of asthma care\u2014could digital interventions provide the key to reducing the carbon footprint of asthma medication?"],"prefix":"10.1093","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5748-3064","authenticated-orcid":false,"given":"Lynn","family":"Elsey","sequence":"first","affiliation":[{"name":"Faculty of Biology, Medicine and Health, University of Manchester , Stopford building, Oxford Road, Manchester M13 9PQ ,","place":["United Kingdom"]},{"name":"Manchester University National Health Service Foundation Trust , Wythenshawe Hospital, South moor Road, Manchester M23 9LT ,","place":["United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Penny","family":"Lewis","sequence":"additional","affiliation":[{"name":"Manchester University National Health Service Foundation Trust , Wythenshawe Hospital, South moor Road, Manchester M23 9LT ,","place":["United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8917-2674","authenticated-orcid":false,"given":"Douglas","family":"Steinke","sequence":"additional","affiliation":[{"name":"Manchester University National Health Service Foundation Trust , Wythenshawe Hospital, South moor Road, Manchester M23 9LT ,","place":["United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannah","family":"Durrington","sequence":"additional","affiliation":[{"name":"Faculty of Biology, Medicine and Health, University of Manchester , Stopford building, Oxford Road, Manchester M13 9PQ ,","place":["United Kingdom"]},{"name":"Manchester University National Health Service Foundation Trust , Wythenshawe Hospital, South moor Road, Manchester M23 9LT ,","place":["United Kingdom"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,9,12]]},"reference":[{"key":"2026021807421276100_ref1","doi-asserted-by":"publisher","first-page":"412","DOI":"10.1136\/thorax-2023-220259","article-title":"Greenhouse gas emissions associated with suboptimal asthma care in the UK: the SABINA healthCARe-based envirONmental cost of treatment (CARBON) study","volume":"79","author":"Wilkinson","year":"2024","journal-title":"Thorax"},{"key":"2026021807421276100_ref2","doi-asserted-by":"publisher","first-page":"2102106","DOI":"10.1183\/13993003.02106-2021","article-title":"The environmental impact of inhaled therapy: making informed treatment choices","volume":"60","author":"Woodcock","year":"2022","journal-title":"Eur Resp J"},{"key":"2026021807421276100_ref3","doi-asserted-by":"publisher","first-page":"849","DOI":"10.1016\/j.jaip.2016.07.007","article-title":"Nonadherence to asthma treatment: getting unstuck","volume":"4","author":"Bender","year":"2016","journal-title":"J Allergy Clin Immunol"},{"key":"2026021807421276100_ref4","doi-asserted-by":"publisher","first-page":"3016","DOI":"10.1111\/bcp.15135","article-title":"The environmental impact of inhalers for asthma: a green challenge and a golden opportunity","volume":"88","author":"Wilkinson","year":"2022","journal-title":"Br J Clin Pharmacol"},{"key":"2026021807421276100_ref5","volume-title":"\u201cBlanket\u201d Switching of Inhaler Types. 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