Download Issue 40 - Ontario Lung Association

Respiratory Health
Educators Interest Group
“Better Breathing
2010! Another great
conference awaits
us…be sure to join
us for some exciting
presentations and
workshops.”
Cathy Relf
ORCS Chair
W I N T E R
2 0 1 0
Features
In this Issue
Smoking: A Cause of
Chronic Disease That
Can Be Treated
A review of pharmacotherapy
for smoking cessation . . . . . .1
Executive Team
Message . . . . . . . . . . . . . . .2
Eye On: Cambridge
Memorial Hospital’s
COPD Clinic
Education, exercise and a
support group help patients
manage COPD . . . . . . . . . . . .3
Lung Association News
Raising awareness of radon risks .5
Continuing Education
Opportunities
Meet your portfolio
requirements . . . . . . . . . . . . . .5
FYI: Transplant Patient
Expense Reimbursement
Program
A new program eases the
burden for patients awaiting
lung transplants . . . . . . . . . . .6
Better Breathing 2010
Register today for this excellent
conference . . . . . . . . . . . . . . .6
This issue of Connections was
sponsored through an unrestricted
educational grant from
AstraZeneca Canada.
I S S U E
3 8
Smoking: A Cause of Chronic
Disease that Can be Treated
Ann Bartlett, RN, MSc, BScN, CRE, Nurse Clinician, Firestone Institute for Respiratory Health,
St. Joseph’s Healthcare, Hamilton
n Canada, smoking is the leading
provides a “clean” alternative source of
preventable cause of early death,
nicotine that the person who smokes
disease and disability. Tobacco kills
would have otherwise received from
more than 16,000 Ontario residents
tobacco. The aim of NRT is to partially
each year (Ontario Ministry of Health
replace the nicotine otherwise obtained
Promotion 2006). Quitting smoking is
from cigarettes. This may reduce the
the single most effective thing that a
incidence and intensity of withdrawal
person can do to enhance the quality
symptoms induced by nicotine
and length of their life.
abstinence during the first few weeks
ANN BARTLETT
Smoking is a chronic addiction that
of smoking cessation (Ontario Tobacco
may require repeated interventions
Research Unit 2000b). Systematic
over many years. But you can be optimistic. The reviews show that all forms of NRT increase quit
cumulative effect of simply asking about interest rates at 12 months, approximately 1.5 to 2 fold
in stopping and offering to help can be compared with placebo, regardless of the setting
significant. Brodish (1988) found that 80 percent (National Health Committee 2002).
of identified people who smoked, and were
The most useful approach to pharmaadvised to stop smoking, reported that they cotherapies is to recognize that non-pharmawanted to stop smoking.
cological interventions (counseling and other
As a front line health care professional, how supports) remain vital contributors to successful
many times in a day do you ask your clients “do smoking cessation; they should not be considered
you smoke?”, and if “yes”, “do you want to inferior to drug treatment. In fact, a robust
quit?” A minimal smoking cessation intervention evidence base exists supporting the combination
can last from 1 to 3 minutes using the “Ask, of non-pharmacological and pharmacological
Advise, Assist, Arrange” protocol with all interventions to aid in smoking cessation
clients. All Respiratory Health Educators are (Coleman 2004).
ideally positioned to have daily opportunities to
The following table outlines commonly used
assist all clients to stop smoking and discuss first-line medications for information purposes
therapies available in Canada.
only. In special circumstances or in cases of
contraindications, health care professionals must
Pharmacotherapy – Nicotine Replacement
work in collaboration with the client’s physician
Therapy (NRT)
to determine the appropriate treatment for the
NRT is the most commonly used pharma- client.
cological treatment for smoking cessation, which
Continued on page 4
I
The RHEIG
Executive Team
Ann Bartlett, RN, MSc, BScN, CRE
Firestone Institute for Respiratory
Health, St. Joseph’s Healthcare,
Hamilton
(905) 522-1155 ext. 33726
Debbie Coutts, RRT, CRE
Credit Valley Hospital, Mississauga
(905) 813-1100 ext. 6720
Julie Duff Cloutier, RN, BScN,
MSc, CAE
Faculty of Nursing, Laurentian
University, Sudbury
(705) 675-1151 ext. 3815
Diane Feldman, RRT, CRE
The Lung Association, Toronto
(416) 864-9911 ext. 274
Jane Lindsay, BScPT
Conestoga College Institute of
Technology and Advanced Learning,
Kitchener
(519) 748-5220 ext. 3443
Ana MacPherson, RRT, CRE, MASc
The Lung Association, Toronto
(416) 864-9911 ext. 258
Shelley Prevost, RRT, MASc(c)
St. Joseph’s Care Group, Thunder Bay
(807) 343-2412
Lorelei Samis, BScPT
St. Mary’s of the Lake Hospital, Kingston
(613) 544-5220 ext. 2245
Connie Sivyer, RRT, MASc, CAE
Windsor Regional Hospital, Windsor
(519) 254-5577 ext. 52810
Executive Team Message
Lorelei Samis, BScPT, Physiotherapist and COPD Educator, St. Mary’s of the Lake Hospital,
Providence Continuing Care Centre, Kingston; Chair, Respiratory Health Educators Interest Group
n the last few weeks, I was fortunate
Pulmonary Resection for Cancer,
enough to be enjoying some southerly
Literacy and Lung Health and
warm weather and able to relax enough
finally, Asthma and Allergies. We
to read the daily local newspaper.
encourage all of our members to
Albeit, not regarding our country or
attend and would ask for your help
province, I was drawn to several
in informing your colleagues and
articles discussing the ongoing fight to
co-workers about this educational
ban smoking in restaurants and bars
afternoon.
and smoking in the general population.
During our afternoon of workshops
LORELEI SAMIS
It made me stop and think about how
at Better Breathing, we will be
far we have come in terms of fighting
conducting our Annual Meeting. We
for respiratory health in Ontario, not just in are always looking for new Executive Team
regards to smoking but in other areas as well. So members as well as ideas for the Connections
much has been accomplished in just a few years newsletter. Please approach any member of the
and everyone should be proud of all the work current executive if you are interested in joining
they do in the respiratory health field. But, there our team or if you have an idea for future
is still much work to be done.
workshops or newsletter items.
So as we approach mid-winter, it is a difficult
In case you have not heard, there is a new
time of the year to feel upbeat and energized addition to Better Breathing 2010.
about work. What better way to renew your sense
Breathe!, an Evening of Inspiration to Benefit
of enthusiasm than to attend Better Breathing Lung Health Research, is an off-site fundraising
2010. Running from Thursday, January 28 to event on Thursday, January 28, 2010 at 6 p.m.
Saturday, January 30, 2010 at the Toronto The guest speaker is Dan Buettner, author
Marriott Downtown Eaton Centre, this yearly of the book The Blue Zones – Lessons for Living
conference is a wonderful opportunity to learn Longer from the People Who’ve Lived the
and network with fellow healthcare professionals Longest. For more information or tickets, consult
who work in the respiratory field.
your registration package or www.on.lung.ca/
The Respiratory Health Educators Interest breathe.
Group is once again delighted to be hosting a
As always, we hope that you find this edition
workshop on the afternoon of Thursday, January of Connections interesting and informative.
28th from 11:30 a.m. to 3:45 p.m. A wide range
We encourage everyone to attend and are
of topics of particular interest to respiratory looking forward to seeing familiar faces and
health educators will be presented. This year’s making new friends at Better Breathing 2010.
workshops include an Update on the Ontario
Lung Health Strategy, Ethical Issues at the End
Sincerely,
of Life, Physiotherapy Care Pre and Post
The RHEIG Executive Team
I
ORCS staff:
Sheila Gordon-Dillane, Director
(416) 864-9911 x236;
[email protected]
Heather Wood, Administrator
(416) 864-9911 x256;
[email protected]
www.on.lung.ca/orcs
RHEIG Connections is the newsletter of
the Respiratory Health Educators Interest
Group of the Ontario Respiratory Care
Society, a section of The Lung Association,
573 King St. E., Toronto ON, M5A 4L3.
Opinions expressed do not necessarily
represent the views of The Lung
Association.
2
ORCS and RHEIG Membership
To become a member of the Respiratory Health Educators Interest Group (RHEIG) and
receive this publication three times each year, join the Ontario Respiratory Care
Society, a section of The Lung Association for health care professionals,
and select the optional RHEIG membership. ORCS membership for the year
2010-2011 costs $40 and the RHEIG supplementary fee is $15 (total $55). Two year
memberships are available.
Visit www.on.lung.ca/orcs for details.
C ONNECTIONS W INTER 2010
EYE ON:
The COPD Clinic at the
Cambridge Memorial Hospital
Loretta McCormick, RN (EC), BScN, PHC NP, COPD Educator, Cambridge Memorial Hospital, Cambridge, Ontario
September 2009, our guest
he Chronic Obstructive
speaker was a patient with COPD
Pulmonary Disease (COPD)
who had made significant gains
Clinic at Cambridge Memorial
in strength, endurance and
Hospital (CMH) was developed
breathlessness management. He
in 2007, to serve patients with
encouraged the group of new
COPD in the community of
patients to integrate regular
Cambridge, Ontario. The mandate
exercise into their lifestyle in an
of the Outpatient COPD Clinic is
effort to maintain their current
to manage COPD by preventing
LORETTA McCORMICK
level of function and quality of life.
the progression of the disease,
The COPD Clinic is a Primary Health
alleviating symptoms in patients to
maximize their function with the goal of Care nurse practitioner led interdisciplinary
improving function and quality of life. The team of health care professionals, working in
Clinic is located in the outpatient department collaboration to clinically manage patients
and serves the 120,000 residents of diagnosed with Chronic Obstructive
Cambridge, of which 24% or 28,000 adults Pulmonary Disease (COPD) to maximize
are estimated to be smokers. The COPD their state of health, well being and quality
Clinic is open weekly Monday to Thursday. of life. Specific program objectives include:
• Assessment, monitoring and treatment of
patients with COPD in accordance with
Referral Process: The COPD Clinic at the
current Canadian Clinical Practice (CCP)
Cambridge Memorial Hospital accepts
Guidelines
patients by referral from physicians only.
• Pharmacological management in conjunction
with current CCP guidelines
COPD Enrollment: Patients accepted into
the COPD clinic will meet the following criteria: • Patient and caregiver education, including
smoking cessation, medication management,
• Physician referral with a confirmed
the role of exercise, nutrition and weight control
diagnosis of COPD (FEV1/FVC ratio<0.7)
• Spirometry testing within the last 6 months • Prevention of exacerbations and hospital
re-admissions
• Pulmonary Function testing if available.
• Enhancement of quality of life and
FIGURE 1: Ways to Prevent a Flare-Up
functional capacity.
T
1. Wash your hands frequently
2. Stop smoking
3. Regular Immunizations: a. Annual Influenza
b. Pneumococcal (every 5-10 years)
4. Take medications as ordered
5. Exercise regularly
6. Learn more about COPD
Source: COPD Recommendations - 2008 Primary Care Update
Patient/Family Education: Group education
sessions are held monthly for new patients
in the clinic to review the 6 strategies for
maintaining good health (see Figure 1) and
to provide information related to such topics
as: breathing strategies, energy conservation
including the 4 P’s of managing activity (see
Figure 2), inhaler use, the use of oxygen,
medications, the benefits of being smokefree, and recognition of symptoms.
Education of patients and their family
members is paramount to assisting patients
to manage this chronic illness. In
W INTER 2010 C ONNECTIONS
services in the Cambridge Memorial
Hospital including pharmacy, laboratory
services, spirometry and pulmonary function
testing and diagnostic imaging services.
Patients with COPD who are current
smokers are supported in their efforts to
become smoke-free.
Ongoing Management: Assessment of the
patient is ongoing. A management plan is
developed in partnership with patients, with
referrals to the health care team members
and regular follow up in the clinic to ensure
progress towards goals. The management plan
may include assessment of their physical
function by the kinesiologist, and the
development of an individualized exercise
program. This twice weekly program takes
place in the gym, and includes components
of muscle strengthening, cardio-vascular
training, and education regarding breathing
strategies. The program is four months in
duration, after which the patient is supported
for the transition to a community program,
and encouraged to continue regular exercise
as part of their new lifestyle. Individualized
management plans may include a referral to
any one of the many experts such as the
dietitian for weight management strategies
and the development of a dietary plan, or the
physiotherapist for chest physio instruction
for patients and family members.
Initial Visit: Patients are assessed in the
clinic by a respirologist and nurse
practitioner on their initial visit. At this
time, an individualized management plan is
developed in partnership with the patient.
COPD Support Group: Recently a
support group has formed in Cambridge,
Ontario to provide opportunities for patients
and families in the community to share their
experiences with COPD in a safe and
Meet the Team: The team of health care supportive environment.
We at the COPD Clinic realize the value
professionals in the clinic includes:
respirologists, a nurse practitioner, physio- of such programs and are hopeful that other
therapist, occupational therapist, dietitian, sites will offer similar programs providing
kinesiologist, and support through existing access to education, exercise and management
for patients with COPD in other communities.
FIGURE 2: 4 P’s of Energy Conservation
The COPD Clinic is the recipient of an
Pacing: maintain a good balance between rest and activity Advanced Clinical Practice Fellowship from
the Registered Nurses Association of Ontario.
Planning: organize your work schedule
As the Fellow, the nurse practitioner will be
Prioritizing: order activities by importance
working with a team of mentors and clinic
Positioning: avoid excessive stooping and stretching
health care professionals implementing
Source: Jacobs, M., & Angstadt, K. (2007). 4P’s to improve quality of
the Best Practice Guideline: Integrating
life in residents with COPD. Assisted Living Consult, 27-29.
Smoking Cessation into Daily Practice.
3
Smoking: A Cause of Chronic Disease that Can be Treated... Continued from page 1
PHARMACOTHERAPY TABLE: NICOTINE REPLACEMENT THERAPY (NRT)
MEDICATION INFORMATION
DOSAGE/DURATION
DIRECTIONS FOR USE
PROS
CONS (Side Effects)
Nicotine patch
(i.e., Nicoderm®)
21mg. x 4 weeks*, 14mg.
x 4 weeks, 7mg. x 2
weeks.
Apply to non-hairy, clean,
dry site above the waist and
hold several seconds to
secure. Change placement
site with each new
application every 24 hours.
Easy to use.
Provides steady level of nicotine
throughout the day. Reduces
amount of bolus required.
Discreet.
May cause sleep disturbances. (If
No prescription needed.
7, 14 or 21mg.
Absorbed through the skin.
Nicotine Gum
(i.e., Nicorette®, Nicorette Plus®)
No prescription needed.
25 cigarettes or more per day = 4mg. gum
(Nicorette Plus®) Less than 25 cigarettes
per day = 2mg. gum (Nicorette®).
(*Start and continue with
strength matching to
nicotine dependence.)
1-2 pieces per hour, or
with urge, up to 20 pieces
a day, (or as required)
gradually reduced over
4-12 weeks.
No prescription needed.
Is a mouthpiece with a nicotine cartridge insert.
Each cartridge contains 10mg. but delivers
4mg. nicotine vapor with 2mg. absorbed.
Absorbed by the buccal mucosa. Acidic foods
or drinks interfere with absorption. Do not eat
or drink (except water) for 15 minutes prior.
Nicotine Lozenge
(i.e., Nicorette®, Thrive®)
No prescription needed.
2, 4mg. dosages.
Bite gum once or twice,
then “park” the gum
between the cheek and
gum. Slowly repeat “bite,
park” every minute or so.
If the area around the patch becomes
red, itchy or irritated, try a new site.
If the irritation continues or
becomes worse, notify your doctor.
Substitutes a piece of gum
for the craving of a cigarette;
provides oral gratification
and satisfies nicotine
cravings.
Burning in throat.
Addresses both the physical
and behavioral dependency
of smoking as it mimics the
hand-to-mouth ritual of
smoking.
Flexible dosing. One puff
delivers less nicotine than
one puff from a cigarette.
Faster delivery of nicotine
than patches.
Irritation of mouth and throat.
Hiccups if chewed too quickly.
Dental problems. (Will not bother
dentures until gum is soft.)
One piece will last 30
minutes. If chewed too
fast or swallowed, may
produce stomach upset.
Absorbed by buccal mucosa, but
diminished by use with coffee, tea, alcohol,
juice and soft drinks.
Nicotine Inhaler
(i.e., Nicorette®)
Once a day application.
bothersome, remove patch once in bed and
immediately apply new patch in morning.)
6 – 16 cartridges/day.
Number of puffs taken
depends on the amount
of nicotine required by
individual’s cravings and
dependence. (Most users
require > 2 puffs at a
time).
“Puff (into mouth) and
hold”. Same cartridge may
be used to address the
next craving. Once
opened, each cartridge
should be changed every
24 hours because the
unused nicotine will
evaporate.
Sneezing.
Stomach upset with overuse.
Device visible when used.
Up to 6 months.
Similar to that of gum; 1 2 lozenges per hour for 6
weeks, with a dose reduction over the
second 6 weeks or as
cravings decrease.
4mg. dose is recommended May satisfy oral behaviour.
for smokers who smoke
within 30 minutes of
awakening (a measure
of greater nicotine
dependence).
Mouth irritation.
Dyspepsia.
Hiccups.
Absorbed by the buccal mucosa.
Bupropion Hydrochloride
(Zyban®, also marketed as the
anti-depressant Wellbutrin® SR)
Requires a prescription.
150mg. oral tablet.
Exact action mechanism is unknown,
(presumed to alleviate cravings of nicotine
withdrawal affecting noradrenaline and
dopamine) - may be key neurochemical
components of the nicotine addiction pathway.
Varenicline Tartate
(i.e., Champix™)
Requires a prescription.
0.5 – 1mg. oral tablet.
Works as mixed agonist and antagonist.
Agonist activity provides stimulation of
receptor, giving partial replacement of
cigarette effect, while agonist blocks the
ability of nicotine to stimulate the central
nervous mesolimbic dopamine system.
4
150mg./day for the first 3
days, then 150mg. twice a Start 7-14 days before quit
date.
day until treatment is
complete.
Easy to use. (pill form).
Can be used in combination
with NRT.
Contraindications for use in
individuals with: seizure, central
nervous system tumor, bipolar
disorder, alcohol withdrawal,
benzodiazepine withdrawal, use of
monoamine oxidase inhibitor,
anorexia, bulimia and liver disease.
Duration of treatment is
generally 8 weeks, but
can be used for up to 1
year for the prevention of
relapse.
0.5mg. /day for the first 3
days (5-7 days before quit
date). Then 0.5mg twice a
day for the next 4 days
(days 1-4 before quit
date) and 1 mg. twice a
day (starting on quit day).
Insomnia.
Seizure. Gastrointestinal disturbance.
Jitteriness.
Start 7-14 days before quit
date.
Duration of treatment is 12
weeks or can be longer
(9 up to 24 weeks) for the
prevention of relapse.
Easy to use. (pill form).
Can be used in combination
with NRT.
Nausea, vomiting, constipation,
flatulence, bad taste in mouth,
abnormal dreams, sleep
disturbance, depressed mood,
agitation, changes in behaviour,
suicidal ideation and suicide.
Take with food to avoid GI
upset and at least 250mls.
(8 ounces) of water.
C ONNECTIONS W INTER 2010
LUNG ASSOCIATION NEWS
Continuing Education
RADON IN OUR HOMES…
OPPORTUNITIES
Helping your patients clear the air indoors
Brian Stocks, BA, MEd, Air Quality Manager, Ontario Lung Association
s a health professional,
carcinogenesis. Although radonyou may be asked about
related lung cancers are mainly
radon by your clients in the
seen in the upper airways, radon
coming months.
The Lung
increases the incidence of all
Association is working with
histological types of lung cancer,
Health Canada to promote
including small cell carcinoma,
awareness of this potentially
adenocarcinoma, and squamous
serious lung health risk.
cell carcinoma. An individual’s
Radon is a colourless,
risk of getting lung cancer from
BRIAN STOCKS
odourless gas that is produced
radon depends mostly on three
from the natural breakdown of
factors: the level of radon, the
uranium in rocks and soil. Radon can duration of exposure, and their smoking
enter a home through tiny openings in habits. Either smoking or radon exposure
floors and foundations and build up to can independently increase the risk of lung
dangerous levels. Long-term exposure to cancer; however, exposure to both greatly
radon is the second leading cause of lung enhances that risk.” 1
cancer in Canada. For smokers, the risk
The only way to know if a home has high
of developing lung cancer from radon radon levels is to test. Health Canada
exposure is even higher. The Ontario recommends long term testing, for a
Lung Association is partnering with minimum of three months, between
Health Canada to
September
and
raise
awareness
April, when doors
about the health
and windows are
effects of long-term
typically
closed.
exposure to radon
Testing is easy and
gas and to promote
inexpensive, and
the testing of
test kits can be
homes. By learning
purchased
from
major home supply
about the health
stores such as
risks
associated
with radon and how to test for it, exposures Home Hardware (if not on the shelf, ask
them to order you one) and Wal-Mart, as
can be reduced.
Radon is found across Canada and any well as the Radiation Safety Institute
home can be at risk. The level of radon in a (1-800-263-5803), Becquerel Laboratories
home depends on many things, including (613-589-2456) or Bubble Technology
the amount of uranium in the soil, the Industries (1-877-726-3080).
To obtain the brochure Radon – Is It In
number of entry points into the home,
and the type and level of ventilation. Your Home? Information for Health
Radon levels can vary between Professionals, visit The Lung Association’s
neighbouring homes and even within a website, www.on.lung.ca/radon. Print
versions can also be obtained by speaking
home from day-to-day.
According to information supplied by with a Certified Respiratory Educator at
Health Canada, “inhaled radon decay The Lung Association, at 1-888-344-5864,
products can become deeply lodged in the or from Health Canada at 1-800-O-Canada.
lungs, where they emit ionizing radiation A brochure for consumers is also available
which can penetrate the cells of mucous should you wish to distribute copies to your
membranes, bronchi, and other pulmonary patients.
tissues. The ionizing radiation energy
affecting the bronchial epithelial cells is 1 Radon – Is It In Your Home?: Information for
believed to initiate the process of Health Professionals. Health Canada. 2008.
A
W INTER 2010 C ONNECTIONS
January 28–30, 2010*
Better Breathing 2010, From Better Breathing to
Best Lung Health – Toronto Marriott Downtown
Eaton Centre Hotel. www.on.lung.ca/bb10.
February 25, 2010*
ORCS Essex/Kent Region seminar – Serbian
Centre, Windsor.
March 11-13, 2010
IUATLD North American Region’s annual
conference, Under One Sun: Looking
Ahead, Working Together, Moving Forward –
Orlando, Florida www.bc.lung.ca/lungdiseases/ tuberculosis_iuatld.html.
April 15, 2010*
ORCS Greater Toronto Region spring educational evening - Fairview Library, North York.
Details to follow.
April 29–May 1, 2010
Canadian Respiratory Conference – World
Trade and Convention Centre, Halifax, Nova
Scotia. www.lung.ca/crc.
May 14–19, 2010
American Thoracic Society annual conference,
Where Today’s Science Meets Tomorrow’s Care.
New Orleans, Louisiana. [email protected].
May 13–16, 2010
Canadian Society of Respiratory Therapy
National Conference and Trade Show. St.
John’s, Nfld. www.csrt.com.
June 2-5, 2010
5th International Primary Care Respiratory
Group World Conference, 2010 – Making
every breath count, Westin Harbour Castle,
Toronto. www.ipcrg-toronto2010.org.
June 17, 2010*
ORCS Greater Toronto Region educational
evening and Annual Meeting – Auditorium,
Women’s College Hospital, Toronto. Details
to follow.
July 22-25, 2010
Canadian Physiotherapy Association National
Congress 2010 – St. John’s, Nfld. www.
physiotherapy.ca.
*For further information on ORCS programs,
call (416) 864-9911, ext. 256, e-mail orcs@
on.lung.ca or visit www.on. lung.ca/orcs.
For the schedule of 2010 Provider Education
programs, visit www.olapep.ca.
For the schedule of 2010 CAMH TEACH
programs, visit www.camh.net.
For the schedule of 2010 RespTrec/SpiroTrec
courses, visit www.resptrec.org.
5
Better Breathing 2010:
FYI: Transplant Patient Expense
From Better Breathing
to Best Lung Health
O
LAST
CHANCE T
O
REGISTER
!
Don’t miss the annual RHEIG session
at Better Breathing 2010!
WHEN: Thursday, January 28 – Saturday, January 30, 2010
WHERE: Toronto Marriott Downtown Eaton Centre Hotel,
525 Bay St., Toronto
Register today for Better Breathing 2010, the annual conference of
the ORCS and OTS. The conference includes plenary sessions,
workshops, a poster session, exhibits and exciting social events.
On Thursday, January 28, the RHEIG will host its annual half day
session, featuring a lecture on the Ontario Lung Health Strategy
and workshops on Ethical Issues at the End of Life: A Respiratory
Care Perspective, Physiotherapy Pre and Post Pulmonary
Resection for Cancer, Literacy and Lung Health and Asthma and
Allergies. Friday’s sessions feature plenary speakers on the theme
of Environment and Lung Health and many clinical topics of
interest to health professionals from all disciplines. The ORCS
Annual General Meeting will be held during the Friday afternoon
session. Don’t miss the ORCS Poster Presentations Reception
and a repeat of last year’s successful social event with the OTS,
Just What the Doctor Ordered!, on Friday evening. Saturday’s
program includes concurrent workshops and sponsored breakfast
and lunch sessions.
For the complete Better Breathing program and to register,
visit www.on.lung.ca/bb10 or call Heather Wood at 416-8649911 x256.
NOTICE OF ANNUAL MEETING
The Annual Meeting of the ORCS-RHEIG will be held during the
Workshop at 1 p.m. The agenda will include reports on the year’s
activities, membership and election of the Executive Team for
2010-2011. Nominations for membership on the RHEIG Executive
Team, which meets by conference call approximately 5 times per
year, are welcomed. Contact [email protected] if you are interested
in putting your name forward or nominating a colleague.
Reimbursement Program
n May 1, 2009, the Trillium Gift of Life Network launched the
Transplant Patient Expense Reimbursement Program (TPER).
Patients waiting for heart, heart-lung, or lung transplantation who
are required to relocate near the transplant hospital for the purposes
of transplantation may now apply for reimbursement of qualified
relocation accommodation expenses incurred May 1, 2009 and
onwards. TPER is a Ministry of Health and Long-Term Care funded
program. Trillium Gift of Life Network is administering the program.
The purpose of TPER is to assist in alleviating the financial
burden on patients waiting for heart, heart-lung or lung
transplantation who are required by the transplant hospital to
relocate within reasonable proximity of the transplant hospital to be
wait-listed and/or to obtain post-transplant surgery discharge care.
Ultimately, TPER aims to facilitate access for these patients to
transplant services.
Program Eligibility
All applicants to TPER must be insured under the Ontario Health
Insurance Plan (OHIP). Eligible patients are those waiting for
heart, heart-lung or lung transplantation who reside more than 2.5
hours driving distance from the transplant hospital as determined by
the transplant hospital and have, as a condition of being listed for
transplantation, temporarily relocated within proximity of the
transplant hospital prior to being listed for transplantation OR are
pending listing for heart, heart-lung or lung transplantation, reside
more than 2.5 hours driving distance from the transplant hospital
and are required to relocate near the transplant hospital. All
applicants are required to declare all other sources of funding they
have received to directly cover or partially cover relocation
accommodation expenses (e.g., David Foster Foundation).
Expenses Covered
TPER will reimburse relocation accommodation expenses up to a
maximum of $650 per month, and up to a maximum of $7,800 for
12 months for eligible applicants. In addition, TPER may reimburse
up to a maximum of 2 months (or as required for medical reasons
related to transplant surgery) of relocation accommodation
expenses after post-transplant surgery discharge. TPER only
reimburses accommodation expenses related to relocation. Specific
examples of accommodation may include apartment/condominium
rental, family/friends who provide receipts, Ronald McDonald
House and temporary hotel accommodations. Utility, telephone and
transportation costs are not eligible. Completion of an application
and submission of supporting documentation are required. Prepayment of expenses may be an option for those receiving
government support or social assistance.
To determine if your patients are eligible for TPER, contact the
transplant hospital or Trillium Gift of Life Network. Participating
heart, heart-lung and lung transplant programs include: The Ottawa
Heart Institute, University Health Network (Toronto General
Hospital), The Hospital for Sick Children and London Health
Sciences Centre. Application forms are available at transplant
hospitals and www.giftoflife.on.ca or 416-619-2342/1-888-977-3563.
Source: Trillium Gift of Life TPER Bulletin I, May 1, 2009.
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C ONNECTIONS W INTER 2010