Strategies Relating to the Prevention of the Chronic Obstructive Pulmonary Disease Condition - Coursework Example

RUNNING HEAD: CRITICAL REVIEW OF FRAMEWORKS, STRATEGIES AND APPROACHES RELATING TO THE PREVENTION OF THE CHRONIC OBSTRUCTIVE PULMONARY DISEASE CONDITION Critical Review of Frameworks, Strategies and Approaches Relating to the Prevention of the Chronic Obstructive Pulmonary Disease Condition Name Institution Date Introduction For several years now, Chronic Obstructive Pulmonary Disease condition has remained a key public health concern globally. According to Nolte & McKee (2008), this particular condition is among the leading causes of the endless morbidity and ultimately mortality, where it is ranked fourth globally. It is as well projected to be ranking fifth overall in terms of global disease burden by the year 2020. Chronic Obstructive Pulmonary Disease condition has significant impacts on a patient’s life quality, as a result, being linked to long-term medical care among the affected individuals, regular admissions in hospitals for exacerbation treatment and in many cases premature death (Beghe et.al (2008). Despite this, Chronic Obstructive Pulmonary Disease remains somehow unknown or disregarded by public health officials, government officials and the general public. According to Donner & Lusuardi (2010), the prevention of this particular condition including risk factors underpinning its development forms a significant health priority for the coming decades hence the need for appropriate frameworks, strategies and approaches aimed at the prevention. Various frameworks, strategies and approaches, which are basically high-level, generic policies, have been developed and recommended for prevention by various expert groups as well as individuals, including policy makers, non-governmental organization members, leading clinicians, peak consumer organizations and other related health organizations. Each of the frameworks, strategies and approaches have been highlighted by the Global Initiative for Chronic Obstructive Lung Disease (2013) to be structured such that they reflect the particular phases of a patient’s journey but with varying effectiveness in both primary as well as secondary prevention. This particular paper therefore intends to critically compare and contrast frameworks, strategies and approaches recommended for use by an interdisciplinary team for the prevention of the Chronic Obstructive Pulmonary Disease condition. According to Nolte & McKee (2008), it is clearly evident that practical, achievable approaches are urgently needed in order to develop health systems so as to be able to meet both the present and the future demands with regards to the prevention of chronic diseases as a major health challenge, including Chronic Obstructive Pulmonary Disease. As noted by the Centers for Disease Control and Prevention (2011), the risk of acquiring the Chronic Obstructive Pulmonary Disease condition is currently known to have an association with the exposure to risks across the life course. As such, one of the approaches, as emphasized by the National Public Health Partnership (2001), is the “Whole of Life” approach. The National Public Health Partnership (2001) highlights the significance of employing the “whole of life” approach towards the prevention as well as health promotion regarding the chronic condition. This particular approach emphasizes the significance of a systematic identification, prioritization as well as the application of various cost-effective interventions as a comprehensive strategy in the prevention of this chronic condition within the various phases throughout the life course. This particular approach highlights various strategies within each of the four disease’s life stages that address the major risk factors associated with the chronic condition. The approach as well incorporates other key strategies for health improvement that can be delivered within common settings such as school settings and primary health care settings. The health promotion and preventive strategies, including tobacco control, form the key priorities areas. The significance and the impacts of various settings applicable to the varied life stages of the disease are thus emphasized as fundamental arenas for the appropriate health action among the population. On the other hand, emerging scientific evidences propose the need for moving beyond the static model of the lifestyle risk, while still acknowledging continuous significance of action within this area, to one that is based on the lifecourse perspective recognizing the interactive as well as the cumulative impacts relating not only to the social but biological influences throughout the life, in particular, the significance of early-life factors in developing a predisposition towards chronic diseases during adulthood. As the Salford Primary Care Trust (2009) notes, there is currently a new body of evidence (scientific) pointing out the significance of taking greater considerations regarding the impacts of the interactive as well as cumulative exposures not only to risk factors but also protective factors (biological, environmental, social and behavioural) throughout the life course so as to clearly understand and take action on matters relating to health disparities. As such, the Salford Primary Care Trust (2009) argues that health outcomes tend to be highly optimal with the promotion of good health throughout life, right from pre-natal stage and infancy. Recent studies, for instance, reveal that adverse events like exposure of the foetus to the tobacco smoke, lower birthweight; repeated infections, malnitrution and neglect during ones early life years often establish the predisposition to various chronic conditions. Going with the global strategy recommendations and in light of the various challenges involved, this framework recommends the building of an organization of prevention efforts focusing on three major activity domains. Among the domains include ensuring the establishment of an information base that is quite effective, strengthening prevention alongside health promotion and improving the care systems for chronic disease patients. In terms of the establishment of the information base, Juvelekian & Stoller (2013) highlights critical factors including systematic/methodical surveillance of the risk factors together with their determinants, systematic/methodical development of evidence base in order to inform program development and policy and evaluation/performance measurement. On the other hand, with regards to strengthening prevention and the promotion of health, critical factors highlighted include the reduction of risks factors along with the determinants, promoting health throughout lifecourse, building partnerships not only for inter-sectoral action but also supportive policies for the public and giving priorities to populations greatly at risk (The Australian National Preventive Health Agency, 2013). Levy (2008) similarly highlights that in terms of improving the care systems for chronic disease patients critical factors include improvement in terms of early disease detection and its intervention, strengthening the prevention role within the health system, integrated health systems as well as care partnerships alongside consumer participation. On the other hand, whereas the Chronic Disease Action Plan (CDAP) proposes an approach applicable to the care of all chronic diseases and conditions, it prioritizes on the preventable chronic illnesses that often cluster around the common bio-medical risk factors, behavioural risk factors and the environmental risk factors. As highlighted by the South Australia Department of Health (2009), this particular clustered approach mainly aligns with National Chronic Disease Strategy 2005, with the chronic obstructive pulmonary disease as one of the chronic respiratory illnesses being among the identified focus for the targeted action. While other chronic conditions such as developmental conditions, chronic renal illnesses, neurologiocal conditions and genetic conditions have been little consideration within the plan, the chronic obstructive pulmonary disease has been accorded a greater significance owing to it being among the greatest disease burdens, being largely preventable and especially through lifestyle modification, being able to be modified not only through environmental changes but also through policy changes and having the ability to be effectively managed so as to enhance health outcomes. Prevention strategies towards such a chronic disease remain significant bearing the fact that recent data particularly from South Australia demonstrated a high burden associated with such prioritized chronic illnesses. According to Grant et.al (2009), a study reported that almost half of the South Australians of 18 years and above suffered from no less than one chronic condition, which is a slight increase from the previous studies. Whereas this particular increase had no great significance, the South Australia Department of Health (2009) argues that the study as well raveled a dramatic rise in the numbers of people reporting more than two chronic conditions, with chronic respiratory illnesses including the chronic obstructive pulmonary disease being reported mostly within the study. According to the South Australia Department of Health (2009), addressing the major risk of this particular condition can greatly assist with its prevention. The South Australia Department of Health (2009) highlights that such risk factors can basically be considered as modifiable behaviours/conditions directly to the chronic disease development. The strategic framework through the clustered approach thus focuses its action on the major risk factors that are both common and shared by the prioritized chronic conditions. The cluster however is specific and does not incorporate all the chronic conditions and illnesses, nor does it include every possible risk factor. The initial objective is to enhance co-ordination within a manageable and sizeable number of the related conditions actually known to be quite preventable, share the pathogenesis and risk factor commonalities, and make up a greater proportion of the overall burden associated with the disease (Clini et.al, 2013). According to this particular approach, targeting the shared major risk factors has the capability of preventing or delaying progression while also assisting in the condition’s management. According to the South Australia Department of Health (2009), focusing on the risk factors is mainly associated with the primary prevention. However; healthy behaviours/lifestyles are also highlighted as playing a significant role in the disease prevention strategies (through tertiary prevention and secondary prevention strategies). Generally, the South Australia Department of Health (2009) asserts that the clustered approach to the risk factors associated with the chronic obstructive pulmonary disease is a highly effective approach towards the prevention of this prioritized chronic condition. The most commonly acknowledged cluster initiative within Australia is SNAP framework which emphasizes on the significance of smoking, nutrition alcohol and physical activities in chronic disease prevention (Esteban, 2010). According to the South Australia Department of Health (2009), smoking and excessive alcohol consumption is considered as chronic conditions within themselves. Addressing such risk factors through the promotion of healthy choices thus form the key objective of the nationally-agreed health reform programs as well as processes. The highlighted approach is thus used in a number of current strategies as well as initiatives. On the other hand, despite the efforts aimed at preventing the highlighted condition, Frith et.al (2008) argues that actions need to systematically address not only the various interventions such as reducing smoking among the lower socioeconomic groups through the primary healthcare/public health initiatives but also address the various social determinants. According to the Tasmania Department of Health and Human Services (2013), health inequality plays a significant role as disproportionate burden and is often experienced by the disadvantaged groups despite the control of behavioural risk factors. Grouse (2012) highlights further that addressing the issue is often a challenging task hence inequalities remain persistent and hard to change. Such social determinants include education, infancy, housing and income. According to the Department of Health, Medical Directorate, Respiratory Team (2011) therefore, such a measure may possibly close the gap between the morbidity rates and the life expectancy across all divides (the rich and the poor).Similarly, Government of Western Australia (2012) argues that injury prevention, which is a national health priority area has been excluded in the initial cluster version arguing that effective action around the identified areas within the framework ought to contribute to the prevention of injury as the chronic disease is either indirectly/directly associated with injuries. Government of Western Australia (2012) however additionally states that injury in itself cannot be considered as a disease and that a number of interventions aimed at preventing injury occur within different domains and focused on various risk factors, for instance not wearing protective clothing/mask while working in an environment where smoke/air pollutants may be inhaled. Government of Western Australia (2012) therefore suggests that in given settings including schools and aged-care institutions, prevention of the chronic disease ought to be coordinated alongside initiatives towards injury preventions. A whole-of-health system approach has also been highlighted by Nolte & McKee (2008), as key to the prevention of the highlighted chronic condition. According to Nolte & McKee (2008), this particular approach articulates that in every step within the development as well as the progression course of a chronic disease, there are often vital prevention and health benefit opportunities. The approach thus highlights the significance of integrated planning in the prevention as well as control of the chronic disease throughout a particular health system so as to at least ensure that there is consistency in terms of lifestyle advice and a further reinforcement of the messages throughout the system levels. According to this approach, there are also vital opportunities to enhance health literacy, empowerment and support. From this point of view, the potential role of the whole health system towards prevention and the general health promotion definitely remains vital, however still remaining a mostly untapped resource as the Department of Health (2009) argues. Also, according to the Australian National Preventive Health Agency (2013), the conceptualization involved may frequently offer the basis for effective dialogue mainly between clinicians, allied professionals and public health workers with regards to the respective roles played by various areas in the improvement of health as well as the creation of collaboration and joint planning opportunities. In technical forms, this particular framework may offer the basis for the identification of data requirements, economic modeling, workforce development, resource allocation and service planning. In Australia, for instance, the whole-of-health system response proposed by the framework is made available nationally through National Public Health Partnership Group (NPHPG) and National Health Priority Action Council (NHPAC) collaborative agreement as well as through collaborative agreements involving other bodies that include the non-governmental sector and the National Institute for Clinical Studies (Fleming & Parker,2008). Within the overall approach, NPHPG’s interest is reflected within the front-end of the care continuum, which are primary prevention as well as health prevention that are directed at common/major risk factors as well as the social health determinants. According to the approach, early detection and screening are fundamentally crucial measures in terms of disease control.However; the early detection mention above only pertains to preventable conditions within the cluster. The proposed strategy therefore includes the formation of an executive group consisting of strategy leaders reporting to the main institutions involved. The group can often meet at least twice a year to review progress reports, consider long-range scenarios and recommend appropriate work programs. Additionally, establishment of broader membership body comprising of members from the NGOs, research institutions, consumer organizations, public health, government and primary health, and who are responsible for the prevention of the chronic disease as well as the health promotion is fundamental(Department of Health, 2009). Such a mechanism is to be reflected in every jurisdiction, regional as well as local levels as applicable. The national body also ought to be consistent with the World Health Organization recommendation and meet at least annually. Despite the opportunities highlighted by the approach, Kendall (2010) argues that there are also challenges flowing from this particular approach. According to Kendall (2010), the key challenges revolve around developing a stronger approach towards prevention and re-orientation of the system around primary healthcare. On the other hand, as highlighted by Nolte & McKee (2008),despite the opportunities presented by this approach, strong linkages ought to be built throughout the various levels within the health system, especially between the prevention domain, early detection domain, management domain and the on-going care domain. This should be regarded as an integral part of the comprehensive approach towards the reduction of the chronic disease burden. Conclusion This paper has critically evaluated the various frameworks, strategies and approaches relating to the prevention of the Chronic Obstructive Pulmonary Disease Condition. The various frameworks, strategies and approaches highlighted in this particular paper indicate the various dimensions that have been employed in improving the coherence in terms of the public health efforts aimed at minimizing the burdens associated with the Chronic Obstructive Pulmonary Disease Condition, improving the general health/wellbeing and effectively exploiting resources in order to attain shared goals. The frameworks complement a wide range of various initiatives towards health improvement including strategies focusing on the populations greatly at risk, reforms on primary healthcare to effectively support individuals against Chronic Obstructive Pulmonary Disease, preventive programs aimed at minimizing harm related to drug/substance abuse as well as broader initiatives for strengthening communities apart from building social capital. The approaches proposed to a larger extent ensures continued independence as well as the autonomy of every strategy and the agencies dealing with the highlighted condition or its risk factors, while also offering the organizational and the conceptual basis for the establishment of the shared programs including co-ordination of the various efforts to add value. While the public health action aimed at preventing the above highlighted condition is directed from a national level by the concerned bodies, the implementation of the recommended actions as highlighted in this particular paper will require a partnership involving local communities, the community-care sector and primary health care sector. This particular paper therefore takes supports that while control is particularly better than developing complications, prevention is often better than actual cure. 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