Asthma Cycle of Care Program - Case Study Example

Asthma has an individualized effect on every person. It can be as severe as it can cause death [although this is very rare] and it can just be as occasional as it only comes twice a year in a manageable level. Due to this circumstance, it can be observed that asthma is defined differently in each book available which had made it difficult to point out that the definition provided in this study is the exact definition of the disease. Treatments, likewise, more probably will differ individually too. All the same, this paper will present gathered information about asthma, how it works, what its causes and its effects are, and the treatments available that can be utilized by asthmatics depending on the severity of their conditions. Furthermore, this paper will also tackle the Asthma Cycle of Care program initiated by the Australian government and its health department in the treatment and care applicable for Patient X. This report was made possible through an exploratory research method in collecting available data both in print and non-print resources. Reading materials include books, journals, pamphlets and internet articles. Since conditions of asthmatics indeed differ from one person to another, the important thing that must remembered is the responsibility of the people affected in caring for themselves. Medical solutions are significant. However, the effectiveness of the treatment does not depend on that only. People with asthma like Patient X must not rely on medications alone but also do their part in preventing or limiting reoccurrence by doing applying suggested management plans specified by their health care providers. Knowing Asthma Introduction Asthma is a chronic condition that affects the lungs. This results to an “occasional tightening of the air passages” (1) which makes the people who have asthma suffer from periods of breathlessness due to their difficulty to allow air to travel in and out of their lungs secondary to this reaction process. Since it is chronic and has no total cure, asthmatics are advised to follow individually-specific management plans that involve a multi-factorial treatment to prevent worsening of their present conditions. The management plans include medical treatments, environmental and lifestyle positive manipulations. To be able to understand how this works, this paper will try to explain the mechanism of asthma and how it affects its victims. At the same time, this paper will discuss the specific treatments made available for Australians to be able to make an effective action plan for Patient X’s case as presented in this study. The Mechanism of Asthma Asthma results to an “occasional tightening of the air passages," especially the bronchioles, which makes it difficult for asthmatic people to efficiently breathe air in and out of their lungs (1). It is incurable and is caused by multiple factors. People become asthmatic due to several reasons. Even though it can be attributed to genetics, there still are many possible ways in which a person can acquire the disease. The development of asthma is triggered by many causes. These include the exposure of a hypersensitive respiratory system to allergens such as dusts and pollens, fumes, polluted air, smokes, infections, some medications and even stress (2). Urbanization is also considered as one of its contributors (3). When the hypersensitive airways come to meet these triggers, people will suffer breathless episodes due to inflammation and edema, constriction, and abnormal hypersecretion of mucus in the bronchial tube muscles (4). In the three major changes that these irritants and “triggers” can result to, inflammation is considered as the foremost important factor. The process of inflammation induces redness, irritation and swelling that leads to the thickening of the respiratory muscles (5). This thickening results to the narrowing of the bronchial tubes which serves as the way for air to pass in and out of the lungs. Secondly, bronchospasm “causes the airway to narrow further” (5). Here, chemical mediators such as histamine, heparin and leukotrienes are released in response to allergens as a result of mast cell degranulations. When degranulations occur, bronchospasm then constricts the surrounding muscles of the bronchial tubes impeding the delivery of oxygen to the lungs (6). The third physiological alteration that is also prominent in asthmatic patients is mucus hypersecretions. Actually, secretions are a natural defense. It is normal that when an allergen comes in contact with the airways, mucus is produced to protect its linings. In asthma, however, excessive sticky mucus is produced (7). If not expelled or lysed properly, these mucus secretions form plugs that block the passages of air in the lungs. In totality, these mechanisms initiate an increased need of oxygen to those who are suffering of asthma. They experience recurrent attacks of breathlessness. That is why asthmatics usually tend to breath faster, a mechanism most asthmatics frequently rely on, which is in fact not good (8). Fast breathing makes it even more difficult for air to enter and go out of the lungs. Coughing, wheezing and shortness of breath are the other main symptoms of the condition. These, furthermore, prove that asthmatics are not able to achieve normal process of breathing during an asthma attack (9). Treatment of Asthma The treatment of asthma depends naturally on the recipient’s condition. Because it is not curable, they are basically “aimed at controlling symptoms and preventing serious exacerbations” (10). These treatments are mainly grouped into long-term and quick-relief medications; but the combination of both is also available. Quick relief medications are designed to relieve symptoms as soon as they are felt by the patient. They are used as needed and ideally should only be utilized “less than once a week on an average” (11). The widely used quick-relief medication is the kind bronchodilators contained in a metered dose inhaler (MDI). Albuterol, the most commonly used bronchodilator, can be administered through MDI, nebulizer, or as a syrup or pill. Cromolyn sodium, nedocromil and anticholinergics can also be given as prophylactic and as relaxants of the airway muscles respectively (12). It is to be noted, however, that overuse of these quick-relief medications is an indication that asthma is already out of control and needs more effective treatment. Long-term treatments, on the other hand, are made available to serve as an on-going control and management of the symptoms. Long-acting anticholinergics and bronchodilators supply the same effect as the short-term ones but with a longer period effect. Corticosteroids or steroids are also used to soothe the inflamed muscles and lower the rate of hypersensitivity. Immunomodulators and leukotrine modifiers are also given to lessen the effect of the sensitivity process that allergens cause (12). Other Ways to Manage Asthma Aside from the available medical treatments for asthma, lifestyle management is also considered as important (13). This kind of treatment approach is focused on diet and allergy, exercise, and environmental control. Since asthma is caused by “triggers” such as pollens, dust, allergies to food, smoking, and physical and emotional stress, asthmatics, their families, and even those who do not have the disease alike, should direct some changes regarding these aspects to promote overall health condition as this can have major impact to the recurrence of attacks or even to the development of asthma. Asthma in Australia The statistics of asthmatic population in Australia is one of the highest in the world (14). In fact, there are “1 in 7 primary school-aged children, 1 in 8 teenagers and 1 in 9 adults” Australians affected with this disease (15). As a result, the Australian government launched Asthma Cycle of Care as a part of Asthma Management Programme just last year. Asthma Cycle of Care involves an action plan that the general practitioners and the patients both have agreed with in the care of the asthmatics. The treatment is engaged with three types of medical treatments: the groups of preventer, reliever, and symptom controller medicines (16). The preventer medications include beclomethasone, fluticasone, sodium cromoglycate, budesonide, montelukast, and nedocromil. The relievers are several brands of salbutamol and terbutaline; while the symptom controllers [or the long-acting ones] are comprised of eformoterol and salmeterol. There are also available combined forms of relievers and symptom controllers such as Seretide and Symbicort (16). Moreover, the programme provides self-management education and information according to individual condition to relieve Australian asthmatics effectively of the disease. Australian Patient X and his Asthma. As what have been emphasized earlier, frequent use of quick-relief medications is a sign of a worsening condition. It is obvious that Patient X’s health state is indeed getting worse as evidenced by his pattern of medicine use. Initially, it is suggested that Patient X refer his condition to his general practitioner. Yet, basing on his current state and as indicated in the Asthma Cycle of Care, it can be recommended that he can be prescribed with combined formulations relievers and symptom controllers. The combined therapy of short-acting and long-acting treatment can help the patient be relieved of his symptoms earlier and the effects also stay for a longer duration. Therefore, the patient needs not to take short-acting medication frequently as he had. Puffers with these formulations are already available in the markets and can be prescribed by the physician. Consequently, since it is possible that the frequent attacks may be founded by stress or increased exposure to “triggers,” Patient X can make suggested lifestyle and environmental modifications as needed to keep him from suffering frequent attacks of asthma. Conclusion Although asthma is a condition more common in children, people of different ages wherever in the world can still suffer from it. Hence, people – affected or not – should take responsibility of making appropriate measures to prevent any possible development or increase of severity of the disease. Asthma may not be as fatal as the other health problems but having it can probably cost a patient much. Nonetheless, having it should not otherwise limit people from living a normal life. Yes, medicines are available but they must also do their part. Reference List 1. Levy M, Hilton S, Barnes G. Asthma at your fingertips: a Helpful and clearly written book. London, UK: Class Publishing; 2000. 2. MediLexicon International Ltd. All about asthma. [Online] [cited 22 April 2010]; Available from: http://www.medicalnewstoday.com/info/asthma/what-is-asthma.php 3. Frumkin H, editor. Environmental health from global to local. 2nd Ed. San Francisco, CA: John Wiley & Sons; 2010. 4. Hogg JC. The pathophysiology of asthma. CHEST 1982 July;82(1):8s-12s. 5. MedicineNet, Inc. Asthma: how does asthma affect breathing?[Online] [cited 22 April 2010]; Available from: http://www.medicinenet.com/asthma/page4.htm#tocf 6. White GC. Basic clinical lab competencies for respiratory care: an integrated approach. 4th Ed. Clifton Park, NY: Delmar Learning; 2003. 7. Shale DJ, Ionescu AA. Mucus hypersecretion. European Respiratory Journal 2004;23:797-798. 8. Buteyko Asthma Management. An Attack: what happens in an attack? [Online] 1999 [cited 22 April 2010]; Available from: http://www.buteyko.co.nz/asthma/attack/default.cfm 9. Levy M, Hilton S, Barnes G. Asthma at your fingertips: a Helpful and clearly written book. London, UK: Class Publishing; 2000. 10. Gershwin ME, Albertson TE. Bronchial asthma: principles of diagnosis and treatment. 4th ed. Humana Press; 2001. 11. Allen JL, Bryant-Stephens T, Pawlowski NA, Buff S, Jablow MM. The children’s hospital of Philadelphia guide to asthma: how to help your child live a healthier life. Hoboken, NJ: John Wiley & Sons; 2004. 12. Vann M. A quick overview of asthma medication. [Online] 2009 [cited 23 April 2010]; Available from: http://www.everydayhealth.com/asthma/asthma-medication-overview.aspx 13. Vann M. Lifestyle choices are important asthma causes. [Online] 2009 [cited 23 April 2010]; Available from: http://www.everydayhealth.com/asthma/asthma-causes-and-lifestyle-changes.aspx 14. Australian Government Department of Health and Ageing. Asthma statistics. [Online] 2009 February [cited 23 April 2010]; Available from: http://www.healthinsite.gov.au/topics/Asthma_Statistics 15. Australian Government Department of Health and Ageing. Asthma. [Online] 2009 June [cited 23 April 2010]; Available from: http://www.healthinsite.gov.au/content/internal/page.cfm?ObjID=0005939C-0400-1D2D-81CF83032BFA006D&PID=4765 16. Australian Government Department of Health and Ageing. My asthma action plan. [Online] 2006 November [cited 23 April 2010]; Available from: http://www.health.gov.au/internet/main/Publishing.nsf/Content/957D057CE967D0FECA256F1900136C63/$File/Action%20plan%20form%20page%2020%20Feb%202009.pdf Read More