{
  "abstract": "Background: The healthcare sector is a major contributor to greenhouse gas emissions, prompting an urgent need for environmentally sustainable practices. Chronic Obstructive Pulmonary Disease (COPD) management presents unique challenges in this context due to the frequent use of metered-dose inhalers containing high global warming potential propellants and the resource-intensive nature of acute exacerbations.\n\nMethods: This expert consensus paper explores how COPD care can be optimized to reduce environmental impact, while maintaining high standards of clinical effectiveness. We examine the patient journey, adherence patterns, and therapeutic strategies, including the role of single-inhaler triple therapy in preventing exacerbation, as determinants of healthcare-related emissions.\n\nResults: The potential of dry powder inhalers, accurate diagnosis, patient engagement, and sustained disease stability are highlighted as levers for environmentally sustainable care. We advocate for the integration of environmental impact as a formal outcome in randomized controlled trials, supported by standardized Life Cycle Assessment methodologies.\n\nConclusions: Our findings suggest that environmentally conscious COPD management is not only possible but may enhance clinical outcomes and system sustainability.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Health Sciences, University of Milan Respiratory Diseases ward, Papa Giovanni XXIII Hospital, Bergamo, Italy",
    "Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy",
    "Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy",
    "Direzione Medica GSK, Verona, Italy",
    "Pneumologic Unit, Azienda Ospedaliera Universitaria Integrata 37126 Verona, Italy",
    "Department of Biomedical and Clinical Sciences, University of Milan and Division of Respiratory Diseases, Luigi Sacco University Hospital, ASST Fatebenefratelli-Sacco, Milan",
    "Respiratory Diseases Section, Department of Basic Medical Science Neuroscience and Sense Organs, University of Bari, Bari, Italy",
    "Pneumology Unit, IRCCS San Matteo Hospital Foundation, Pavia, Italy and Department of Internal Medicine, University of Pavia, Pavia, Italy",
    "Department of Experimental Medicine, Unit of Respiratory Medicine, University of Rome “Tor Vergata”, Rome, Italy",
    "Division of Pneumology, “V. Monaldi” University Hospital, Naples, Italy",
    "Access to Medicine, GSK, Verona, Italy",
    "Center for Public Health Research, University of Milan–Bicocca, Monza, Italy and Laboratory of Public Health, IRCCS Istituto Auxologico Italiano, Milan, Italy"
  ],
  "article_type": "meeting report",
  "arxiv": null,
  "author_total": 13,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Fabiano Di Marco"
    },
    {
      "affs": [
        1
      ],
      "name": "Federico Lavorini"
    },
    {
      "affs": [
        2
      ],
      "name": "Francesco Pistelli"
    },
    {
      "affs": [
        3
      ],
      "name": "Fabio Arpinelli"
    },
    {
      "affs": [
        4
      ],
      "name": "Claudio Micheletto"
    },
    {
      "affs": [
        5
      ],
      "name": "Pierachille Santus"
    },
    {
      "affs": [
        6
      ],
      "name": "Elisiana Carpagnano"
    },
    {
      "affs": [
        7
      ],
      "name": "Angelo Guido Corsico"
    },
    {
      "affs": [
        8
      ],
      "name": "Paola Rogliani"
    },
    {
      "affs": [
        9
      ],
      "name": "Maria D’Amato"
    },
    {
      "affs": [
        3
      ],
      "name": "Carmen Stabile"
    },
    {
      "affs": [
        10
      ],
      "name": "Federica Piccolo"
    },
    {
      "affs": [
        11
      ],
      "name": "Lorenzo Giovanni Mantovani"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/e3mtjfrvvkfbs.bib",
  "cited_by": 0,
  "doi": "10.5826/mrm.2026.1092",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13722453/",
  "id": "e3mtjfrvvkfbs",
  "issns": [
    "1828-695X",
    "2049-6958"
  ],
  "landing_url": "https://doi.org/10.5826/mrm.2026.1092",
  "language": "en",
  "licence": "CC-BY-NC-4.0",
  "licence_label": "CC BY-NC 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Meeting Report"
    ],
    [
      "openalex",
      "2740|Chronic Obstructive Pulmonary Disease (COPD) Research"
    ]
  ],
  "openalex": "W7224128467",
  "pdf_url": "https://mrmjournal.org/index.php/mrm/article/download/1092/1610",
  "pmcid": "PMC13722453",
  "pmid": "42949561",
  "published": "2026-10-28",
  "publisher": "Mattioli 1885",
  "ris": "https://research.draconitic.com/paper/e3mtjfrvvkfbs.ris",
  "sources": [
    {
      "first_seen": "2026-11-03T12:22:57Z",
      "native_id": "PMC13722453",
      "source": "pmc",
      "url": "https://doi.org/10.5826/mrm.2026.1092"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2740|Chronic Obstructive Pulmonary Disease (COPD) Research",
      "subfield": "general"
    }
  ],
  "title": "Management of chronic obstructive pulmonary disease in the era of environmental sustainability: Can we achieve excellence?",
  "title_text": "Management of chronic obstructive pulmonary disease in the era of environmental sustainability: Can we achieve excellence?",
  "type": "peer-reviewed",
  "updated_at": "2026-11-03T12:22:57Z",
  "url": "https://research.draconitic.com/paper/e3mtjfrvvkfbs",
  "venue": "Multidisciplinary Respiratory Medicine",
  "versions": []
}