Korea Asthma Allergy Foundation

1. Korea Asthma Allergy Foundation You - Young Kim, MD. PhD. Presented at WHO GARD meeting March 28-29, 2006

2. 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

3. Map of the countries where the organization has ongoing activities : South Korea nationwide

4. Contents • Surveillance/Epidemiology • Health Promotion and Disease Prevention • Diagnosis, Control and Drug Accessibility • Pediatric Chronic Respiratory (CRD) and • Allergic Diseases • 5. Awareness of CRD and Allergic Diseases • 6. Health Professional and Public Education

5. 1995 2000 Prevalence of asthma in Korean children (%) 20 p<0.05 9.1% p<0.05 10 7.7% 5.3% 2.7% 0 Elementary school children(6-12 yr olds) Middle school children (12-15 yr olds)

6. Prevalence of current asthma in Korean adults 20 15 Total 10 Prevalence, % Male Female 5 0 20 30 40 50 60 70 Ages

7. 5,000 4,500 4,000 3,500 3,000 2,500 2,000 1,500 1,000 500 0 1983 1985 1986 1987 1988 1989 1990 1991 1992 1993 1995 1996 1997 1998 1999 2000 2001 2002 1984 1994 All age over 60 yrs old 5 to 34 yrs old Asthma Mortality in Korea

8. 1. Surveillance/Epidemiology • Burden of Asthma Project in South Korea • A research, conducted by KAF andGraduated 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

9. 1. Surveillance/Epidemiology • Prevalence rate : 4.18 % (NHIC) • Number of patients : 1,952,594

10. 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 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

11. 1. Surveillance/Epidemiology • Burden of Asthma • 0.15~0.28 % of GDP (including intangible cost) Million dollar

12. 2. Health promotion and Disease Prevention • The Ceremony of the 6th & 7th World Asthma Day • Date : April 11, 2004and 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

13. 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

14. Gap Between Treatment Status in Korea and GINA Goals

15. 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 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

16. Easy Asthma Management KAF Doctor Survey feedback EAM WORK SHOP EAM beta version EAM national version EAM Pilot analysis EAM Pilot Study before after feedback Prescription pattern Prescription pattern HIRA Data Analysis 3. Diagnosis, Control and Drug accessibility

17. Screening by Symptom Give scores for each symptoms Symptom Based Diagnosis

18. Differentiate other possible cardiopulmonary diseases 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

19. 3. Diagnosis, Control and Drug accessibility Diagnosis & treatment Defines Patient’s severity Shows Prescriptive Drugs Diagnose and prescribe upon severity

20. 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

21. 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

22. 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

23. 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 : • Pediatric asthma is not common disease for student (86%) • Pediatric asthma is allergic disease and it need long term management (92%) • 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

24. 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% ofnursing teachers want asthma educational course • - Develop and provide asthma management manuals

25. 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

26. 5. Awareness of CRD and Allergic Diseases Newspaper over 670 press release about asthma and information in 2004 and 2005 Korea Economic Daily Maeil Business Newspaper Donga Weekly

27. 5. Awareness of CRD and Allergic Diseases Newspaper Asthma Experience Event Maeil Business Newspaper Yonhap news Cho sun daily

28. 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

29. 6. Health professional and public education For Public Information Homepage :www. Kaaf.org

30. We propose to hold WHO/GARD Meeting in Korea