Transcript Inspire at Work Asthma Project

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
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.
The Participants
105 Participants enrolled in the study with 99
completing it (5.7% drop-out)
Breakdown by Participant Type:
1%
20.2%
Employees (73)
Spouses (5)
Dependents (20)
Other (1)
5.1%
73.7%
•69.7% Female
•30.3% Male
•Average Age 39yrs
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
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
Medication Adherence/Usage
Inhaler Technique:
Percentage of patients
with a score of 4 (S)
100
98.0
50
27.7
Baseline
3 months
0
4
Average Score (S)
2
0
3.97
2.85
Baseline
3 months
Economic Outcomes - Absenteeism
Self-reported paid work
days lost over past 3
months by employee
participants (NS)
1
0.5
Self-reported school 1.5
days lost over past 3
1
months by
0.5
child/dependent
0
participants (S)
0.86
0.15
Baseline
9 months
0
1.16
Baseline
9 months
0
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)
100
90
95.9
80
100
90
Baseline
9 months
85.4
96.0
88.6
Baseline
9 months
80
6
4
5.3
1.8
2
Overall, Inspire at Work appears to have0had a positive
impact on workplace productivity.
Baseline
9 months
Return on Investment (ROI)
 Costs
associated with delivering the
program:
•
Asthma Educator’s 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
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?
The percentage of patients
Do you cough, wheeze or have a tight chest
who answered ‘no’ to all 5
because of your asthma?
questions. (S)
Do coughing, wheezing or chest tightness
wake you at night?
100
Do you stop exercising because of your
61.6
asthma?
35.2
Baseline
50
Do you ever miss work or school because of
9 months
your asthma?
0
Overall, Inspire at Work had a positive impact on asthma symptoms
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.
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.