Asthma management research paper

WHO reports in 2016 indicated that over 383,000 people died due to asthma with the majority of the deaths occurring in low- and middle-income countries(WHO, 2019). This assignment aims to discuss the pathophysiology, standard practice, and resources for the management of asthma, evaluate factors that are pertinent to the management of the condition and discuss the impact of the condition to communities, families and identify strategies to promote asthma management. Pathophysiology of Asthma The causes of asthma involve an interplay between genetics and environmental factors with no definitive cause of the inflammatory process that results in asthma yet to be identified. The common causes of asthma include genetic predisposition, innate immunity and environmental factors such as allergens (dust, mites, pollen among others). Asthma pathophysiology is complex and involves the inflammation of the airways (bronchioles), bronchial hyperresponsiveness and obstruction of airflow through the airways(King, James, Harkness & Wark, 2018).

The smooth muscle constriction in asthmatic reaction contributes to characteristic wheezing experienced in asthmatic attacks. Hyperinflation due to reduced expiration results in dyspnea during asthmatic attacks. Standard Practice for Asthma management The management of asthma is dependent on the dynamics of the individual patient's presentations. The management of asthma is dependent on the severity of the disease, the patient's age and the existence of comorbidities. All pharmacological management approaches are made following comprehensive patient assessment and medical history to ensure safety and efficacy of treatment. The long-term control medications are prescribed to achieve effective control of persistent asthma. The Long-term medications used include; corticosteroids, immunomodulators, leukotriene modifiers, long-acting beta-agonists (LABA) and Methylxanthines (Utah Department of Health, n. d. The preferred pharmacological management for intermittent asthma in my state is the use of LABA which are prescribed together with environmental management for the patient to avoid allergens, patient education and the management of any comorbidities.

Persistent asthma is managed in a 5-stage process depending on the severity (Utah Department of Health, n. The recommended approach for quick relief is the use of SABA for symptomatic relieve or the use of short-course systemic oral corticosteroids. Asthmatic management with SABA for more than 2 days in a week for the relief of symptoms is regarded as an indicator for inadequate control of asthma and requires a step-up treatment. The State's asthma management protocols enable the community to achieve not only the therapeutic outcomes from the treatment but also to effectively manage the risks for future asthmatic attacks. This is achieved by the incorporation of patient education and environmental management in patient care which ensures a more patient-centered approach to care.

The utilization of asthma management programs helps to achieve better control of asthma in the community as well as incorporating caregivers in asthma management. In allergic asthma, an allergy diagnosis is made from the patient's history and allergic testing such as skin prick or Immunoglobulin group E definition is conducted (Horak et al. The common differential diagnosis for asthma in adults includes other chronic obstructive pulmonary diseases, sinusitis and gastroesophageal reflux disease (Horak et al. Asthma management aims to achieve a sustained maximum benefit and freedom from the symptoms and an improvement in the quality of life. The achievement of maximization in patient outcomes can be achieved through a combination of medical and patient education. The patient education intervention should include the provision of basic information about asthma, education on self-management for asthma and development of a written asthma action plan(Horak et al.

The other treatment modalities for asthma is similar in both the national and state practice guidelines. Resources for patient management of Asthma The effective management of asthma among patients is dependent on their ability to access good and high-quality health care services. According to the Asthma and Allergy Foundation of America (AAFA), the access to a healthcare team and more so a specialist team such as Pulmonologists, immunologists or allergists provides better patient outcomes of care. To effectively manage asthma, patients ought to have access to asthma specialists. Some of the factors that may affect the accessibility of healthcare teams include distance to get access to asthma specialists, lack of insurance coverage, social-economic factors such as poverty and increased exposure to pollutants which are irritants among others.

The medication also ought to be efficacious and tolerated by the patient to ensure the patient has a high quality of life. Asthmatic patients with well-managed disease have a longer life expectancy compared to those with poorly managed asthma. Well managed asthmatic patients can live a normal life to within the standard life expectancy while those with poorly controlled asthma are at risk of early mortality due to asthma complications. Well managed asthma is characterized by almost complete control of asthmatic symptoms and complete environmental management to prevent re-occurrence of the disease. The outcomes of well-managed asthma are; reduced asthmatic attacks and complications requiring specialized management, almost complete control of the environmental triggers of the disease, enhanced ability to participate in exercise and other activities and enhanced health literacy on asthma.

The lack of financial and health capacities to develop strategies to control and prevent the condition has also led to increasing prevalence (Nunes, Pereira and Morais-Almeida, 2017). The disparity in income in most low- and middle-income countries coupled with the high cost of care and limited access to insurance leads to high treatment disparities for asthma. Low- and middle-income countries have fewer asthma specialists compared to the National level access to asthma specialists which increases disparities between the national and international levels. Factors that contribute to a patient being able to manage asthma Financial resources: The annual estimated cost per patient each year for the management of asthma is $ 3,000 in the USA. This cost includes the cost of asthmatics throughout the year(Nunes, Pereira and Morais-Almeida, 2017).

Insured Vs Uninsured The cost of care for asthma is usually high with the USA having the highest asthma per patient care cost per annum. Access to health insurance cautions the patient from bearing the burden of the high cost of care and ensures the ability to access medications, health education, and treatment in case of complications. To ensure effective asthma management patient ought to have adequate insurance cover with patients with no insurance having been linked to poor care outcomes such as increased asthma exacerbations, asthma-related complication needing hospitalization among others (Soril et al. Lack of insurance, financial resources and access to healthcare-impact in asthma management The lack of insurance declined financial resources and decreased access to healthcare are all interlinked in the care and management of asthma.

The presence of asthma is associated with a high social-economic cost ranging from the direct cost of care such as medications and hospital visits to the indirect costs such as time lost from work (Perwitasari & Retnowati, 2016). Children diagnosed with asthma face significant life challenges in asthma management with reduced self-esteem due to limited ability to participate in physical activities such as games, disruptions in their social functioning and the need to frequently carry or utilize asthma medications (Stridsman, Dahlberg, Zandrén & Hedman, 2017). Such children may be viewed as different by others or feel alienated more so where the disease information or knowledge is limited. Children diagnosed with asthma are likely to miss school more often compared to those with no asthma diagnosis (Stridsman, Dahlberg, Zandrén & Hedman, 2017).

Parents with children diagnosed with asthma are likely to suffer fatigue and depression associated with the care for such children while children may suffer a guilty conscience and lowered esteem due to the strain, they cause their family and parents (Abu-Shaheen, Nofal & Heena, 2016). Adult asthmatic patients similarly face significant challenges such as limitation in the work and time lost at work. Strategies to Improve Asthma Management Inpatient asthma education is one of the important strategies that I will utilize in improving the management of asthma in the organization. Patient education is a critical aspect of care often overlooked inpatient care. Introducing inpatient asthma education will incorporate initiating patient education early during their hospital admission or first contact with the healthcare system and establishing patient follow-ups to ensure efficiency.

Implementing early patient education prevents the last-minute rush in educating the patient at discharge and enhances their understanding of asthma and its care modalities. The success of the strategy can be measured using patient follow up to evaluate their adherence to medication, environmental management to minimize triggers. In conclusion, asthma is a serious chronic illness that can, however, be effectively managed through a series of interventions that requires patient, family, community and healthcare engagement. Asthma causes a significant burden of care financially and emotionally to individuals with asthma and a significant economic cost for the country's economy. The availability of financial resources, access to specialized care teams and health insurance play a significant role in the prognosis of asthma. Despite the enhanced healthcare systems in the USA, care disparities persist, and the disparities internationally are more pronounced due to among other factors; differing healthcare priorities, availability of funding, cost of medical care and level of care guideline implementations.

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