Evaluation of a Workplace Asthma Self-Management Program

Abstract

Background:

Asthma impacts employers in the form of reduced productivity and increased absenteeism and health care costs. To address this, a workplace self-management wellness program, “Inspire at Work,” was developed by a benefits carrier with the purpose of improving the health and productivity of patients with asthma.

Methods:

A cohort of patients (employees and the family members of employees in 7 large companies in New Brunswick) enrolled in the program was followed over 9 months. The intervention consisted of 2 pre-scheduled, private educational sessions, including a complete asthma assessment along with spirometry testing, with a certified asthma educator, and 2 follow-up assessments. The ECHO model was used to capture a range of Economic, Clinical and Humanistic Outcomes. Most outcomes were measured at 4 time points and were collected via survey. Changes in continuous variables across the 4 time points were evaluated using a oneway repeated measures design, while changes in dichotomous variables were evaluated using the Cochrane's Q Test.

Results:

One hundred and five patients were enrolled in the program, with 99 patients completing all 4 sessions. Forty-six drug-related problems (DRPs) were identified in 34 patients. The most common types of DRP were untreated indications (20 patients), failure to receive drugs (12 patients), and subtherapeutic dosage (11 patients). A statistically significant improvement was seen in absenteeism, productivity, public payer costs, and in scores related to quality of life (modified Living with Asthma Questionnaire), the 30 Second Asthma test, participant satisfaction, and inhaler technique. The Return on Investment was $4.24 for each dollar spent.

Conclusions:

An asthma educator, proactively helping patients at the workplace, can discover many gaps in asthma care and improve many asthma-related outcomes. Employer-benefits carrier partnerships, as exemplified by this workplace wellness program, have many potential advantages, including increased accessibility to care. As Canada's publicly funded health care system continues to deal with problems related to access to care, innovative partnerships at the workplace may be one viable method to improve the convenience of care and outcomes for patients.