Asthma and COPD Management Paper
Asthma and COPD management present multiple challenges to compliance (inhalers, smoking, allergens, etc.). Discuss a typical patient scenario, along with strategies that you as the primary care provider will apply to enhance compliance in the treatment of COPD or asthma. Support your strategy with literature.Asthma and COPD Management Paper
The key purpose of the treatment and management of Chronic Obstructive Pulmonary Disease(COPD)and asthma is to ensure improvement in the functional status and quality of life of a patient through the preservation of optimal lung function and to prevent the recurrence of exacerbation’s. In patients with COPD, there is obstruction of airflow during expiration which puts an increase in breathing and results to dyspnea (Sabaté, Sabatâe & World Health Organization, 2013). On the other hand, there is obstruction of air in patients with asthma which is irreversible and progresses within a long period of time. The general challenge that is presented in the management of COPD and asthma is patient compliance. Therefore, this paper discusses strategies that can be utilized by a primary care provider to enhance compliance in the treatment of asthma.
Patient Scenario
A 45-year-old woman presents with a history of asthma in the emergency Room. Her major complaint is an acute shortness of breath and she also has an audible wheezing. This lady has progressively been taking her prescribed medications of cromolyn sodium and Ventolin inhaler at home until two weeks ago when she stopped citing side effects. Her asthma is not well controlled due to similar non-compliance behavior in the past.Asthma and COPD Management Paper
Strategies to Apply in Enhancing Compliance in the Treatment of Asthma.
To enhance compliance in the treatment of asthma as it is in this case, it is necessary that regimens are negotiated between the patient and primary care provider to agree on a drug the patient is likely to comply with and has less side effects (Sabaté, Sabatâe & World Health Organization, 2013) Another strategy is by educating the patient on asthma and letting her know that it is a chronic illness that needs self-management that will lead to responsibility(Sabaté, Sabatâe & World Health Organization, 2013). The use of directly observed therapy in the short term may also apply after choosing the simplest regimen that is most effective.
Reference
Sabaté, E., World, H. O., Sabatâe, E., & World Health Organization. (2013). Adherence to Long-term Therapies: Evidence for Action. Geneva: World Health Organization.
Asthma is a serious health and socioeconomic issue all over the world, affecting more than 300 million individuals. The disease is considered as an inflammatory disease in the airway, leading to airway hyperresponsiveness, obstruction, mucus hyper-production and airway wall remodeling. The presence of airway inflammation in asthmatic patients has been found in the nineteenth century. As the information in patients with asthma increase, paradigm change in immunology and molecular biology have resulted in an extensive evaluation of inflammatory cells and mediators involved in the pathophysiology of asthma.Asthma and COPD Management Paper Moreover, it is recognized that airway remodeling into detail, characterized by thickening of the airway wall, can be profound consequences on the mechanics of airway narrowing and contribute to the chronic progression of the disease. Epithelial to mesenchymal transition plays an important role in airway remodeling. These epithelial and mesenchymal cells cause persistence of the inflammatory infiltration and induce histological changes in the airway wall, increasing thickness of the basement membrane, collagen deposition and smooth muscle hypertrophy and hyperplasia. Resulting of airway inflammation, airway remodeling leads to the airway wall thickening and induces increased airway smooth muscle mass, which generate asthmatic symptoms. Asthma is classically recognized as the typical Th2 disease, with increased IgE levels and eosinophilic inflammation in the airway. Emerging Th2 cytokines modulates the airway inflammation, which induces airway remodeling. Biological agents, which have specific molecular targets for these Th2 cytokines, are available and clinical trials for asthma are ongoing. However, the relatively simple paradigm has been doubted because of the realization that strategies designed to suppress Th2 function are not effective enough for all patients in the clinical trials. In the future, it is required to understand more details for phenotype s of asthma.
Out with the old, stale air and in with new fresh air. That’s the theme of the two most useful breathing exercises—pursed lip breathing and belly breathing—taught by pulmonary rehabilitation specialists to individuals with chronic lung diseases such as asthma and COPD. Like aerobic exercise improves your heart function and strengthens your muscles, breathing exercises can make your lungs more efficient.
Why Breathing Exercises Help
When you have healthy lungs, breathing is natural and easy. You breathe in and out with your diaphragm doing about 80 percent of the work to fill your lungs with a mixture of oxygen and other gases, and then to send the waste gas out. Lung Help Line respiratory therapist Mark Courtney compares the process to a screen door with a spring, opening and shutting on its own. “Our lungs are springy, like the door. Over time, though, with asthma and especially with COPD, our lungs lose that springiness. They don’t return to the same level as when you start breathing, and air gets trapped in our lungs,” Courtney explains.Asthma and COPD Management Paper
Over time, stale air builds up, leaving less room for the diaphragm to contract and bring in fresh oxygen. With the diaphragm not working to full capacity, the body starts to use other muscles in the neck, back and chest for breathing. This translates into lower oxygen levels, and less reserve for exercise and activity. If practiced regularly, breathing exercises can help rid the lungs of accumulated stale air, increase oxygen levels and get the diaphragm to return to its job of helping you breathe.
Pursed Lip Breathing
This exercise reduces the number of breaths you take and keeps your airways open longer. More air is able to flow in and out of your lungs so you can be more physically active. To practice it, simply breathe in through your nose and breathe out at least twice as long through your mouth, with pursed lips.
Belly Breathing, aka Diaphragmatic Breathing
As with pursed lip breathing, start by breathing in through your nose. Pay attention to how your belly fills up with air. You can put your hands lightly on your stomach, or place a tissue box on it, so you can be aware of your belly rising and falling. Breathe out through your mouth at least two to three times as long as your inhale. Be sure to relax your neck and shoulders as you retrain your diaphragm to take on the work of helping to fill and empty your lungs.Asthma and COPD Management Paper