Evaluation of a Workplace Asthma Self-Management Program

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Evaluation of a Workplace Asthma
Self-Management Program

• Neil J. MacKinnon, Ph.D., FCSHP
• Associate Professor Associate Director for
  Research
• Dalhousie University College of Pharmacy
• Halifax, Nova Scotia

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What is Inspire at Work?

• Medavie Blue Cross, a benefits carrier, partnered
  with 7 employers in the province of New
  Brunswick, GlaxoSmithKline and Dalhousie
  University.
• Information sessions were held in workplaces to
  recruit participants participation was
  voluntary.
• Two pre-scheduled private educational sessions
  were held with a certified asthma educator at 3
  month intervals (60 90 minutes).
• The asthma educator performed an asthma
  assessment and spirometry testing, assessed
  puffer technique and developed an asthma action
  plan with the patient.
• 6 9 months follow-up assessments were
  conducted.

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The Participants
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105 Participants enrolled in the study with 99
completing it (5.7 drop-out) Breakdown by
Participant Type

• 69.7 Female
• 30.3 Male
• Average Age 39yrs

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Asthma-Related Problems Identified

• In total, the asthma educator identified 188
  problems related to asthma care in these 99
  patients, an average of 1.90 problems per
  patient.
• Potential Drug-Related Problems (pDRPs) 53
  identified
• Non Drug-Related Problems (nDRPs) 89 identified
• Drug-Related Problems (DRPs) 46 identified
• Published in the March/April issue of CPJ

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Economic Outcomes Medication Claims data
analysis
Percent Changes Pre vs. Post Asthma Drugs Antibiotics
Inspire at Work Participants 39.10 23.10
Everyone BUT Inspire at Work 17.60 0.00

• The change in asthma drug claims is not
  surprising given the types of DRPs the Asthma
  Educator found
• Need additional therapy
• Need higher dosage
• Non-compliance

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Medication Adherence/Usage
Inhaler Technique
Percentage of patients with a score of 4 (S)
Average Score (S)
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Economic Outcomes - Absenteeism
Self-reported paid work days lost over past 3
months by employee participants (NS)
Self-reported school days lost over past 3 months
by child/dependent participants (S)
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Economic Outcomes - Productivity
Percentage of time you are able to be as
productive as normal while bothered by asthma? (S)
Percentage of work accomplished while bothered by
asthma? (S)
During the past 3 months, how many days did you
experience asthma symptoms at work? (S)
Overall, Inspire at Work appears to have had a
positive impact on workplace productivity.
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Return on Investment (ROI)

• Costs associated with delivering the program
• Asthma Educators time travel costs, marketing
  material, delivery support, data entry, employee
  time, supplies
• Savings realized through
• Increased Productivity (reduced absenteeism and
  reduced presenteeism)

4.24 return on every dollar spent towards the
program
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30 Second Asthma Test
For someone to pass the 30 Second Asthma Test,
they must answer no to all 5 of the following
questions

• Do you use your blue inhaler 4 or more times per
  week?
• Do you cough, wheeze or have a tight chest
  because of your asthma?
• Do coughing, wheezing or chest tightness wake you
  at night?
• Do you stop exercising because of your asthma?
• Do you ever miss work or school because of your
  asthma?

• The percentage of patients who answered no to
  all 5 questions. (S)

Overall, Inspire at Work had a positive impact on
asthma symptoms
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Humanistic Outcomes Quality of Life

• The questionnaire featured 24 questions which
  addressed many asthma-specific QoL issues.
• Sample questions
• Does your asthma limit you in these activities
  over the last 3 months?
• Climbing one flight of stairs
• Did you limit the kind of work or other
  activities that you did?
• For every question in the Quality of Life (QoL)
  survey, there was a statistically significant
  improvement in scores across the 4 times points.

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Conclusions

• Increasing healthcare costs are causing employers
  and benefits carriers in Canada to think of
  innovative solutions to this issue.
• Inspire at Work, while increasing asthma drug
  costs, had a favourable ROI and positively
  impacted clinical and humanistic outcomes.