Partnership in Lung Age Testing and Education (PLATE) Programme A demonstration project to implement a population-based approach for management of asthma, associated allergies and COPD FINAL REPORT Prepared by the Asthma Society of Canada for the Public Health Agency of Canada September 2010 Asthma Society of Canada – PLATE Programme Final Report Acknowledgements This report was made possible through the generous contributions of a number of groups and individuals. We thank them for providing their input, sharing their experiences, expertise and feedback. First, we would like to thank the members of the working group: Susan Elliott, Myrna Dolovich, Cheryl Connors, Christine Hampson, Meridene Haynes, Oxana Latycheva and Michelle Vine. Your input was invaluable and your guidance was integral to the completion of this project. During the project, Susan Elliott and her research assistant Michelle Vine were instrumental in implementing the project activities, and undertaking data analysis and report writing. Special thanks go to Christian Harrington and Huyen Dam for their involvement in Phase II and III data collection and analysis. In the later stages of the work, James Patterson provided descriptive analysis and contributed to report writing. This project required the assistance of a number of Certified Asthma/Respiratory Educators (CAEs/CREs). We thank the following individuals for providing asthma/respiratory education to members of the general public: Laurie Allan, MaryKate Buffett, Philomena Dos Santos-Gokul, Meridene Haynes, Amy Kropf, Angela Shaw, and Janice Woychyshyn. We would also like to thank our community outreach workers/clinic assistants: Adrianna Forde, Mrs. Forde, Daniel Howe, and Kristen Sweeney. From the Asthma Society of Canada specific thanks go to Christine Hampson, Oxana Latycheva, Meridene Haynes, Zhen Liu, and Connie Wong. Finally, we would like to thank the individuals and groups who participated in this project. Specifically, we thank Cheryl Connors from the Canadian Network for Asthma Care and Diana Royce from AllerGen, NCE Inc. for their support during the project implementation. We also would like to extend our thanks to the Public Health Agency of Canada (PHAC)* for providing funds for this important program. *Please note that the views expressed herein do not necessarily represent the views and opinions of the Public Health Agency of Canada. September 2010 Page 1 of 189 Asthma Society of Canada – PLATE Programme Final Report Table of Contents Executive Summary ................................................................................................................................................ 6 1 Introduction ................................................................................................................................................. 10 2 Background ................................................................................................................................................. 12 3 Implementation of Community-Based “Airways Clinics” ...................................................................... 13 3.1 General Clinic Overview .......................................................................................................................... 13 3.2 Programme Recruitment and Participation ............................................................................................. 15 3.3 An Overview of Provided Services .......................................................................................................... 16 3.4 Clinic Promotion ...................................................................................................................................... 18 3.5 Programme Outputs ................................................................................................................................ 19 3.6 Lessons Learned ..................................................................................................................................... 20 3.6.1 What Worked Well? ........................................................................................................................ 20 3.6.2 What Challenges/Barriers Were Presented? .................................................................................. 20 4 Implementation of the PLATE Research Component ............................................................................. 22 4.1 Overview.................................................................................................................................................. 22 4.2 Research Design and Tools .................................................................................................................... 22 4.3 An Overview of the Recruitment Process ............................................................................................... 23 4.4 Research Context .................................................................................................................................... 25 4.5 Phase I Findings ...................................................................................................................................... 26 4.5.1 Clinical and Medication History....................................................................................................... 27 4.5.1.1 Breathing Test (Spirometry) .................................................................................................... 32 4.5.1.2 Education ................................................................................................................................ 33 4.5.1.3 Medication History .................................................................................................................. 34 4.5.1.4 Self-Management Strategies .................................................................................................. 37 4.5.1.5 Allergies .................................................................................................................................. 39 4.5.2 Asthma and COPD Knowledge and Understanding ....................................................................... 39 4.5.3 Smoking History .............................................................................................................................. 41 4.5.3.1 Current Smokers ..................................................................................................................... 41 4.5.3.2 Ex-Smokers ............................................................................................................................ 42 4.5.3.3 Exposure to Second-Hand Smoke ......................................................................................... 43 4.5.4 Physical Activity .............................................................................................................................. 44 4.5.4.1 Breathing Exercises ................................................................................................................ 47 4.5.5 Community Resources ................................................................................................................... 47 4.5.6 Phase I Encounter Data .................................................................................................................. 48 4.6 Phase II Findings ..................................................................................................................................... 49 September 2010 Page 2 of 189 Asthma Society of Canada – PLATE Programme Final Report 4.6.1 Clinical and Medication History....................................................................................................... 50 4.6.1.1 Breathing Test (Spirometry) and Education ............................................................................ 54 4.6.1.2 Medication History .................................................................................................................. 55 4.6.1.3 Self-Management Strategies .................................................................................................. 55 4.6.2 Asthma and COPD Knowledge and Understanding ....................................................................... 57 4.6.3 Smoking History .............................................................................................................................. 59 4.6.4 Physical Activity .............................................................................................................................. 60 4.6.4.1 Breathing Exercises ................................................................................................................ 60 4.6.5 Community Resources ................................................................................................................... 60 4.7 Phase III Findings .................................................................................................................................... 62 4.7.1 Primary Themes .............................................................................................................................. 62 4.7.1.1 Evaluation of Airways Clinics/Effects & Effectiveness of Information ..................................... 62 4.7.1.2 Self-Management Strategies .................................................................................................. 63 4.7.1.3 Lifestyle/Health and Wellness ................................................................................................