Nutrition and Global Health Micheline Beaudry, Ph.D. Université Laval.
Chris Monteith- General Motors of Canada Limited Jim Beaudry - CAW Sal Cimino - Green Shield Canada...
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Transcript of Chris Monteith- General Motors of Canada Limited Jim Beaudry - CAW Sal Cimino - Green Shield Canada...
Chris Monteith - General Motors of Canada LimitedJim Beaudry - CAWSal Cimino - Green Shield Canada
A SMOKING CESSATION PROGRAM
PERSPECTIVE
1) Plan Sponsor
2) Labour
3) Plan Administrator
PERSPECTIVE
1) Plan Sponsor2) Labour
3) Plan Administrator
Plan Sponsor’s Perspective
GMCL/CAW Health and Wellness Program known today as ‘Motoring to Wellness’ launched new smoking cessation program September 2006
Designed for GMCL employees, retirees and their family members
In partnership with Durham Region Health Department and Green Shield Canada
Plan Sponsor’s Perspective
Theme of Fall 2006 campaign Program very timely as the Smoke Free Ontario
Act came into effect May 31, 2006 Key Campaign Messages
– Increase awareness of health effects of tobacco use– Increase awareness of health effects of 2nd hand
smoke– Provide supports to those who wish to quit smoking
Plan Sponsor’s Perspective
Health & Wellness Employee Survey conducted Spring 2006 revealed:– 18.4% GMCL employees were current smokers– 50.5% were considering quitting in the next 6 months
(contemplation) or committed to quitting in next 30 days (preparation)
– 38.3% were not considering quitting
Plan Sponsor’s Perspective
Unique program design included combination of motivation, education and support– Intervention support through pharmacists trained in
clinical tobacco intervention (CTI)– Participants accessing pharmacists support provided
benefit coverage for all NRT– Support material including
• Self-help resources (e.g. websites, phone lines)• CTI trained pharmacist listing
Plan Sponsor’s Perspective
Combination of pharmacotherapy and professional support considered to be program’s key to improve quit rate– GMCL committed to helping participants be
successful – GMCL covered related pharmacist cognitive fees in
addition to NRT costs
Plan Sponsor’s Perspective
180 individuals registered Approximately 50% of those registered took
advantage of the CTI trained pharmacist/NRT coverage offering
Outcomes of that 50% signified success of Program
Health Canada has approved funding support for 2008 Program
PERSPECTIVE
1) Plan Sponsor
2) Labour3) Plan Administrator
Labour’sPerspective
CAW behind initiative 100%– Program excellent example for other sectors of our
Union– Demonstrates value of working closely with benefit
providers to achieve Wellness Program success– Improved quality of life for our members
PERSPECTIVE
1) Plan Sponsor
2) Labour
3) Plan Administrator
Plan Administrator’s Perspective
1) Eligible vs Ineligible benefits
2) Trained Pharmacists
3) Electronic Adjudication
4) Communication
5) Data Mining
Plan Administrator’s Perspective
Eligible vs Ineligible Benefits Oral smoking cessation products (e.g., Champix,
Zyban®) full benefit of the drug plan Nicotine replacement therapy (NRTe.g. patches,
gum) removed from the plan in 2001 due to “unscheduled” status
Programming to “include” the NRT
Plan Administrator’s Perspective
Trained Pharmacists “The intervention was associated with increased
and more highly rated counselling, and a trend toward higher smoking cessation rates, indicating that community pharmacy personnel have the potential to make a significant contribution to national smoking cessation targets.”
Sinclair HK et al. Training pharmacists and pharmacy assistants in the state-of-change model of smoking cessation: a randomised controlled trial in Scotland. Tob Control 1998 Autumn;7(3):253-61
Plan Administrator’s Perspective
Trained Pharmacists About 1,000 CTI trained pharmacists in Ontario
(CTI = clinical tobacco intervention) CTI uses “state-of-change model” for smoking
cessation Engaged chains & banners Over 250 pharmacists committed initially
Plan Administrator’s Perspective
Electronic Adjudication Using the existing claims form CPhA v.3 Tie the “consultative” claim to payment
AND
Allow for ineligible benefits to be eligible on individual basis i.e. pay for patches, gum, etc.
Plan Administrator’s Perspective
Electronic Adjudication Need for pharmacists to understand Presentation was prepared and delivered in
specific areas of concern (e.g. Oshawa, Windsor)
Green Shield website used to inform pharmacists of process; two Green Shield pharmacists dedicated for FAQ & troubleshooting
Plan Administrator’s Perspective
Communication Plan members - basically through GMCL
and CAW with help from Durham Health Pharmacists via mailings, presentations,
faxes, chains, banners
Plan Administrator’s Perspective
Data Mining “How many succeeded?” Also important to note the “persistence”
Number of Patients
Number Relapsed/ Withdrawn
Number Quit % Quit
By Gender a
Male 47 25 22 46.8%
Female 33 25 8 24.2%
By Employee/Dependent b
Employees 53 28 25 47.2%
Dependents 27 22 5 18.5%
Total 80 50 30 37.5% a p= 0.034, Fisher exact test
b p= 0.011, Fisher exact test
Plan Administrator’s Perspective
Persistence Pierce and Gilpin (2002)1:
– Median duration of OTC NRT use: 14.0 days– Mean duration of OTC NRT use: 28.2 days
Uncontrolled Rx2: 39-45 days (mean)
GMCL intervention group2: 61.2 days (mean)