Transcript 2005 PR Plan for KAAF - World Health Organization

Korea Asthma Allergy
Foundation
You - Young Kim, MD. PhD.
Presented at WHO GARD meeting
March 28-29, 2006
Overview
• Name of Organization : Korea Asthma Allergy Foundation (KAF)
• Number of members : 286
• Year of establishment : 2003
• Category : National NGO
• Countries mostly represented : Republic of Korea
• Areas of Respiratory Medicine and Allergy covered : Asthma/Allergy
Map of the countries where the organization has
ongoing activities : South Korea nationwide
Contents
1. Surveillance/Epidemiology
2. Health Promotion and Disease Prevention
3. Diagnosis, Control and Drug Accessibility
4. Pediatric Chronic Respiratory (CRD) and
Allergic Diseases
5. Awareness of CRD and Allergic Diseases
6. Health Professional and Public Education
Prevalence of asthma in Korean children
(%)
20
1995
2000
p<0.05
10
9.1%
p<0.05
7.7%
5.3%
2.7%
0
Elementary school
children(6-12 yr olds)
Middle school
children (12-15 yr olds)
Prevalence of current asthma in Korean adults
Prevalence, %
20
15
Total
10
Male
Female
5
0
20
30
40
50
Ages
60
70
Asthma Mortality in Korea
5,000
4,500
4,000
3,500
3,000
2,500
2,000
1,500
1,000
500
0
All age
over 60 yrs old
5 to 34 yrs old
1. Surveillance/Epidemiology
Burden of Asthma Project in South Korea
A research, conducted by KAF and Graduated school of Public Health of
Seoul National University to estimate the prevalence and the economic
impact of asthma in South Korea
• Methods
Collecting and analyzing data sources from
- Health Insurance Review Agency (HIRA)
- National Survey on Health and Nutrition (NSHN)
- National Health Insurance Corporation (NHIC)
- Ministry of Health and Welfare (MOHW)
- Patient cost survey
1. Surveillance/Epidemiology
• Prevalence rate : 4.18 % (NHIC)
• Number of patients : 1,952,594
no of patient
total
male
estimated prevalence rate
female
total
male
female
0~1
35,750
21,651
14,099
8.04%
9.29%
6.66%
1~4
541,369
302,454
238,915
22.42%
23.96%
20.74%
5~9
352,547
192,912
159,635
10.35%
10.69%
9.96%
10~14
112,465
66,106
46,359
3.51%
3.90%
3.08%
15~19
36,957
19,650
17,307
1.18%
1.20%
1.15%
20~24
37,317
12,916
24,401
0.94%
0.63%
1.26%
25~29
56,453
18,135
38,318
1.39%
0.88%
1.91%
30~34
82,985
27,552
55,433
1.81%
1.18%
2.47%
35~39
79,311
29,202
50,109
1.93%
1.38%
2.51%
40~44
88,175
32,509
55,666
2.05%
1.48%
2.64%
45~49
76,601
28,546
48,055
2.29%
1.69%
2.92%
50~54
67,708
25,910
41,798
2.77%
2.11%
3.44%
55~59
70,344
27,342
43,002
3.58%
2.84%
4.30%
60~64
87,814
35,722
52,092
4.56%
3.90%
5.16%
65~69
81,132
34,590
46,542
5.80%
5.53%
6.02%
70~74
63,311
25,666
37,645
7.08%
7.35%
6.90%
75+
82,355
30,988
51,367
7.83%
8.86%
7.32%
total
1,952,594
931,851
1,020,743
3.96%
4.41%
4.18%
1. Surveillance/Epidemiology
Cost of Asthma
•
•
990 ~ 1,781 million US Dollar (direct+indirect cost)
1,136~ 2,112 million US Dollar (including intangible cost)
Million dollar
HIRA data
NHIC data
direct cost
573
880
indirect cost
417
901
direct + indirect
990
1,781
intangible cost
146
331
total
1,136
2,112
Intangible cost in this table is just WTP(willingness to pay) for a month (not a year); WTP is usually
evaluated higher than true value, but still not decided how much is appropriate
1. Surveillance/Epidemiology
Burden of Asthma
•
0.15~0.28 % of GDP (including intangible cost)
Million dollar
% of
amount
HIRA data
NHIC data
754,245
0.15%
0.28%
2003 Ministry of health and
welfare budget
8,175
13.99%
25.84%
2003 medical security budget
4,616
24.77%
45.76%
2004 GDP
2. Health promotion and Disease Prevention
The Ceremony of the 6th & 7th World Asthma Day
 Date : April 11, 2004 and April 24,2005
 Place : Olympic Park, Seoul
 No. of participants : About 1,200 persons including patients and their
family, consumer each year
 Main Program
- The Turtle Marathon Contest
(famous prowrestler,Mr.Wang Pyo Lee who is a asthmatic)
- Entrusting the Asthma Representative: Asthma Ambassador
- Clean Car Campaign: Campaign of No Smoking in a Car
2. Health promotion and Disease Prevention
2004, 2005 Korea Asthma/Allergy/Atopy Seminar and Exhibition
 Period: July 8-11,2004 and May 3-6, 2005
 Place: Convention and Exhibitor Center (COEX), Seoul
 No. of participants: 30,150 persons in 2004 and 29,043 persons in 2005
 Main Program
- Seminar for experts and general participants
- Event on diagnosing atopy and the lungs age
- Exhibition of environmental management goods
Gap Between Treatment Status in Korea and GINA Goals
GINA Goals
AIRIAP in Korea Survey
Minimal or no symptoms,
including night-time
symptoms
42% of patients report night-time
symptoms in the last 4 weeks
52% report daytime symptoms in the last 4
weeks
No limitations on physical
activities and exercise
56% of respondents reported “some” or “a
lot” of limitation to sport or other vigorous
physical activity
7 work or school days per year, on average,
lost due to asthma
No emergency visits to
doctors or hospitals
30% patients had emergency visits and
14% patients had been hospitalized in the
past year
Nearly normal lung function
65% of patients had never been given a
lung function test
3. Diagnosis, Control and Drug accessibility
Easy Asthma Management Project
To create an easily acceptable practical simplified protocol focusing on the
diagnosis, treatment, monitoring of asthma for clinician to fill the gap
between guidelines and real practice and achieve more successful clinical
outcome in asthma management
Diagnosis
symptoms based severity
classification using electronic CRF
Treatment
fixed and easily remembered drug
usage program
Monitoring
simplified monitoring tools
3. Diagnosis, Control and Drug accessibility
Easy Asthma Management
KAF
Doctor Survey
feedback
EAM
WORK
SHOP
EAM
Pilot
analysis
EAM Pilot
Study
after
before
Prescription
pattern
Prescription
pattern
HIRA Data Analysis
EAM
beta
version
feedback
EAM
national
version
Symptom Based Diagnosis
Screening by Symptom
Give scores for each symptoms
1. Within recent 1 year
Have you had wheezing associated with dyspnea?
Yes
V
Nocturnal aggravation
Provoking
factors
No
Score
2
1
Cold air
v
1
Exercise
V
1
Upper respiratory infection
1
Smoke or air pollution
1
Concurrently with coughing
1
Paroxysmal coughing
1
Dyspnea without wheezing
1
Wheezing without dyspnea.
1
Fluctuation of Above mentioned symptoms
2
Total
4
Sensitivity
Specificity
Positive
Predictability
Negative
Predictability
26.2
87.0
82.1
34.0
Differentiate other possible cardiopulmonary diseases
Differential check points
COPD
Endo TB /
Lung Ca
HF / MI
No or minimal reversibility of airway obstruction
Mainly exertional dyspnea
Smokers common, Chest PA
Consider endobronchial lesion in case of monotonous wheeze
No or minimal reversibility of airway obstruction
Chest PA, sputum exam
Edema, DOE, chest pain
Underlying CV disease
Chest PA, EKG, Cardiac enzyme
3. Diagnosis, Control and Drug accessibility
Diagnosis & treatment
Defines Patient’s
severity
Shows Prescriptive
Drugs
Diagnose and prescribe upon severity
3. Diagnosis, Control and Drug accessibility
Material development
•Dr. Training Material
•Nurse Training Material
•Patient Book for Adults
•Patient Book for Children
•Patient Survey Form
• e-CRF
3. Diagnosis, Control and Drug accessibility
Easy Asthma Management Workshop
10 region 25 workshop 1,939 Drs attended
Workshop registration
Introduction
Korea Asthma
Allergy Foundation
Organize Workshop
e-CRF education
e-CRF Practice
e-CRF Role play
3. Diagnosis, Control and Drug accessibility
EAM Pilot Study
To verify Easy Asthma Management protocol
36 General hospitals
25 workshops
6,193 patients
598 clinics
4. Pediatric Chronic Respiratory (CRD) and Allergic Diseases
Nursing teacher education and asthma care support
To facilitate the improvement of asthma care in school for
pediatric asthma patients
• Conducting research for investigating the reality of asthma care in school
- 1,405 samples among 5,000 elementary, middle and high schools
Concept of nursing teacher :
1. Pediatric asthma is not common disease for student (86%)
2. Pediatric asthma is allergic disease and it need long term management (92%)
3. Patients with asthma has limitation of their school life & must not do exercise (52%)
Understanding asthma & its medication
1. Only 5 % of nursing teachers keep rescue medication ready
2. Only 31% know existence of control medication for asthma and how to use
4. Pediatric Chronic Respiratory (CRD) and Allergic Diseases
• Education and asthma care support (2005)
- Only 5% of nursing teachers have conducted asthma education in school
- 84% of nursing teachers want asthma educational course
- Develop and provide asthma management manuals
5. Awareness of CRD and Allergic Diseases
Activities through various media, including TV and newspapers
to increase public awareness of Asthma
TV
 Period : 2004. 09 ~ 2004. 12 (4 months)
 Contents : messaging effectively the seriousness of asthma by showing
the episode in the case of street, theater, home, respectively, in which
people can suffer from the asthma in daily life.
 Expected effects: Arousing the awareness of the public on the importance
of the management and prevention of asthma
5. Awareness of CRD and Allergic Diseases
Newspaper
over 670 press release about asthma and information in 2004 and 2005
Korea Economic Daily
Donga Weekly
Maeil Business Newspaper
5. Awareness of CRD and Allergic Diseases
Newspaper
Asthma Experience Event
Maeil Business Newspaper
Yonhap news
Cho sun daily
6. Health professional and public education
Providing asthma education, information, research to health professional,
and patients to improve better health outcome
 Health profession
Post Graduate Asthma (PGA) school
- providing the latest information on asthma to young asthma doctors
directed to improving their quality of care
• Period: July 3-4, 2004 and June 18-19, 2005
• Place: Busan
• No. of Participants: 119 doctors in 2004
134 doctors in 2005
6. Health professional and public education
For Public
Information Homepage :www. Kaaf.org