Evaluation of a Workplace Asthma Self-Management Program

1. 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

2. 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.

3. The Participants

4. 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

5. 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

6. Economic Outcomes – Medication Claims data analysis • 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

7. Medication Adherence/Usage Inhaler Technique: Percentage of patients with a score of 4 (S) Average Score (S)

8. 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)

9. 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.

10. 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

11. 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

12. 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.

13. 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.