korea asthma allergy foundation
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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
ContentsContents1.1. Surveillance/Epidemiology Surveillance/Epidemiology
2.2. Health Promotion and Disease Prevention Health Promotion and Disease Prevention
3.3. Diagnosis, Control and Drug Accessibility Diagnosis, Control and Drug Accessibility
4.4. Pediatric Chronic Respiratory (CRD) and Pediatric Chronic Respiratory (CRD) and
Allergic Diseases Allergic Diseases
5. Awareness of CRD and Allergic Diseases5. Awareness of CRD and Allergic Diseases
6. Health Professional and Public Education6. Health Professional and Public Education
7.7%9.1%
2.7%
5.3%
0
10
20
Elementary schoolchildren(6-12 yr olds)
Middle schoolchildren (12-15 yr olds)
(%)(%)
p<0.05
p<0.05
Prevalence of asthma in Korean children
1995
2000
0
5
10
15
20
20 30 40 50 60 70
Ages
Pre
vale
nce,
%
Total
Male
Female
Prevalence of current asthma in Korean adults
0
500
1,000
1,500
2,000
2,500
3,000
3,500
4,000
4,500
5,000
19831984
19851986
19871988
19891990
19911992
19931994
19951996
19971998
19992000
20012002
5 to 34 yrs oldover 60 yrs oldAll age
Asthma Mortality in Korea
Burden of Asthma Project in South KoreaBurden 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
total male 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 4.18% 3.96% 4.41%
no of patient estimated prevalence rate
• Prevalence rate : 4.18 % (NHIC)• Number of patients : 1,952,594
1. Surveillance/Epidemiology
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
Cost of Asthma • 990 ~ 1,781 million US Dollar (direct+indirect cost)
• 1,136~ 2,112 million US Dollar (including intangible cost)
1. Surveillance/Epidemiology
Million dollar
Burden of Asthma
• 0.15~0.28 % of GDP (including intangible cost)
1. Surveillance/Epidemiology
Million dollar
HIRA data NHIC data
2004 GDP 754,245 0.15% 0.28%
2003 Ministry of health andwelfare budget
8,175 13.99% 25.84%
2003 medical security budget 4,616 24.77% 45.76%
amount% of
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
2. Health promotion and Disease Prevention
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
Gap Between Treatment Status in Korea and GINA Goals
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
3. Diagnosis, Control and Drug accessibility
symptoms based severity classification using electronic CRF
fixed and easily remembered drug usage program
simplified monitoring tools
Diagnosis
Treatment
Monitoring
Easy Asthma Management
EAM WORK SHOP
before
after
EAM Pilot
analysis
EAM beta
version
EAM nationalversion
feedback
EAM Pilot Study
HIRA Data Analysis
Prescription pattern
Doctor Survey KAF
feedback
Prescription pattern
3. Diagnosis, Control and Drug accessibility
1. Within recent 1 yearYes
NoScor
eHave you had wheezing associated with dyspnea? V 2
Provoking factors
Nocturnal aggravation 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
Screening by SymptomGive scores for each symptoms Symptom Based
Diagnosis
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
Differentiate other possible cardiopulmonary diseases
Sensitivity Specificity Positive Predictabili
ty
Negative Predictabili
ty
26.2 87.0 82.1 34.0
Diagnose and prescribe upon severity
Shows Prescriptive Drugs
Defines Patient’s severity
Diagnosis & treatmentDiagnosis & treatment
3. Diagnosis, Control and Drug accessibility
•Dr. Training Material
•Nurse Training Material
•Patient Book for Adults
•Patient Book for Children
•Patient Survey Form
• e-CRF
Material developmentMaterial development
3. Diagnosis, Control and Drug accessibility
Easy Asthma Management Workshop 10 region 25 workshop 1,939 Drs attended
Korea Asthma Allergy FoundationOrganize Workshop
Workshop registration Introduction
e-CRF education e-CRF Practice e-CRF Role play
3. Diagnosis, Control and Drug accessibility
25 workshops36 General hospitals
6,193 patients
EAM Pilot Study To verify Easy Asthma Management protocol
598 clinics
3. Diagnosis, Control and Drug accessibility
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
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 Maeil Business NewspaperDonga Weekly
5. Awareness of CRD and Allergic Diseases
Newspaper
Asthma Experience Event
Yonhap news Maeil Business Newspaper
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
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