Introduction: Asthma as the Most Common Chronic Disease in the 21st Century
Background
Asthma is considered one of the greatest scourges of the 21st century for a reason (Centers for Disease Control and Prevention, 2016). Despite the fact that it is no longer a death sentence for the patient, it still suggests that the latter should be subdued to lifelong treatment and is likely to be exposed to an array of risk factors. Therefore, the disorder requires further scrutiny and research so that the possible avenues of preventing and addressing it, as well as possibly creating a cure for it in the future could be outlined successfully.
To embrace the gravity that the problem has gained over the past few decades, as well as the extent to which the issue has grown, one must speculate on the information provided in the recent report published by WHO. According to the organization, in 2014, as much as 334,000,000 people worldwide had asthma (World Health Organization, 2014). Therefore, the issue must be addressed in a manner as efficient and expeditious as possible. Raising awareness must be viewed as the first step toward managing the problem.
Asthma itself is typically termed as a noncommunicable chronic disease that affects lungs and triggers an inflammation of airways, thus, causing breathing issues. Particularly, the airways tighten and become swollen, which makes the process of inhaling air increasingly more complicated for the patient. As a result, asthma attacks ensue. The subject matter, also referred to as flareups and exacerbations, is defined as the situation in which the asthma symptoms manifest themselves in an especially strong way, thus, causing the patient to experience the issues mentioned above. Asthma symptoms include coughing while exercising, laughing, or sleeping, having breathing issues, experiencing chest tightness, having short breath, and the appearance of a wheezing sound in one’s lungs (U.S. National Library of Medicine, 2016).
Locating the factors that contribute to the development of asthma is a rather tricky task since the reasons for some people to develop asthma while others remain perfectly healthy in the same environment have not been determined yet. At present, several theories concerning the origin of asthma and the possible threat factors include smoking (both first- and second-hand types thereof), high levels of environmental pollution and inherent tendencies among some people to develop asthma. A combination of the identified factors is typically viewed as the most likely cause of asthma, though the actual reasons for the disease to occur have not yet been identified (Azalim et al., 2014; Rambabu, Chandran, Prasad, Manikyamba, & Kumari, 2016).
Although asthma symptoms might not sound as threatening as they actually are, one must bear in mind that the lack of proper treatment may result in the patient’s untimely death. Therefore, leaving the problem unattended is not to be viewed as a possible choice of actions. When identifying the symptoms that may be associated with asthma, one must address the allergist immediately so that the appropriate diagnosing procedures should be carried out and that the necessary measures should be determined (National Heart, Lung, and Blood Institute, 2014).
Data Collection
The necessary data was retrieved from relevant sites of global organizations aimed at addressing health issues, such as WHO. Furthermore, online databases, such as ResearchGate and Pubmed, were used to download the articles that address the issue of asthma. The necessary data was located with the help of keywords such as “asthma symptoms,” “asthma factors,” “asthma diagnosis,” and “asthma treatment.”
Diagnosis and Treatment of Asthma: Nipping the Problem in the Bud
Asthma is typically diagnosed with the help of a combination of a physical examination of the patient and the analysis of their health record. The latter involves a detailed assessment of the family history, as well as an overview of the health issues that the patient has had so far. A physical examination presupposes that typical symptoms of asthma described above, including wheezing, cough, swellings in nasal passages, etc., should be identified accordingly.
However, when it comes to locating the most efficient test for determining whether the patient has asthma, one must give credit to the tests designed specifically for this purpose. The lung function test is, perhaps, the most widely used one in defining asthma in patients. Also known as spirometry, the test suggests that the volume of the inhaled air, as well as the frequency of breathing, should be measured to identify any inconsistencies in the respiratory system’s functioning. As a rule, asthma is suspected in case the frequency of breathing is lower than the established norm. Coupled with other factors, such as the harshness of breathing, the problems with inhaling and exhaling, etc., the identified characteristic of the patient’s lungs functioning allows diagnosing asthma.
Although the outcomes of the test described above provide a rather solid foundation for diagnosing asthma, one must bear in mind that other methods of detecting the problem exist. For instance, the tests associated with detecting the allergies that the patient may have can be viewed as complementary to the general asthma test. Even though they should not be viewed as substitutes for the testing described above, they help narrow down the process of searching for the appropriate treatment strategy.
In addition, the test that determines the sensitivity of one’s airways should be viewed as one of the methods of detecting asthma in patients. Known as bronchoprovocation, the framework serves as the foil for identifying the changes in the patient’s lungs in the course of performing a physical activity. Finally, EKG, as well as chest X-raying, should be viewed as possible tools for determining the problem. The tests are only useful, however, in case an alien object obstructs the airways and prevents the patient from breathing. Furthermore, other diseases, such as pneumonia, may be detected in the process. Because of the specifics of the disease, the efforts of the contemporary healthcare organizations are aimed at not only providing the patient with a short-term relief but also creating the long-term strategy that will help the patient sustain health at the required level. Therefore, the treatment process can be defined as lifelong for asthma patients.
Assumptions Inherent in the Current Literature: What Available Data Offers and What Missing Information Suggests
The current assumptions in literature as far as the issue of addressing asthma is concerned revolve primarily around sustaining the required health rates among the target patients. Because of the specifics of asthma and the need to control the patient’s condition throughout their entire life, the economic aspect of managing asthma has recently been viewed as one of the issues that need addressing (O’Neill et al., 2013). Indeed, in light of the fact that the process of managing the disorder is likely to take an unlimited amount of time, it will be essential to introduce the tools that will help the target audience control the costs and, therefore, create the environment in which the further development of health issues could be avoided successfully. Therefore, the tendency to consider the economic aspect of treating asthma can be deemed as rather logical.
Treatment of Asthma: Key Approaches, Their Strengths and Weaknesses, and Future Opportunities
Pharmacological Treatment
Much to the dismay of both patients and therapists, asthma belongs to the list of diseases that cannot be cured at present. As a rule, the disease is controlled by prescribing specific medicine to the patient. It should be noted, though, that not all cases of asthma are treated with the help of the same medicine – quite on the contrary, every instance is analyzed as a specific problem that needs an individual approach based on the unique needs and characteristics of the patient. Consequently, several types of asthma medicine exist.
The pharmacological treatment of asthma typically includes the consumption of control agents. Among the latter, inhaled corticosteroids (ICS) and long-acting bronchodilators (particularly, beta-agonists and anticholinergics) have recently been viewed as the common treatment tools. According to the recommendations provided by the National Heart, Lung, and Blood Institute (2013), the identified tools allow for taking a better control over the key symptoms of asthma; as a result, the patient experiences a significantly lesser discomfort compared to the instances of an unattended asthma issue. The effectiveness of ICS can be explained by their anti-inflammatory nature. To be more specific, the identified type of medication helps reduce the hyperresponsiveness by which asthma patients can typically be characterized. As a result, the primary symptoms of asthma are reduced to a minimum, triggering an immediate relief in patients. On a cellular level, the identified medication prevents the migration and the further activation of the inflammatory cells. Consequently, it would be wrong to claim that the identified type of medicine allows preventing the problem from occurring. Instead of eliminating the factors that launch the process, it merely pauses one of the latest stages of an asthma attack.
One might argue that the identified type of medicine has significant side effects that are not to be overlooked. Indeed, evidence shows that the consumption of ICS may cause problems in the physical development of children; particularly, a growth impairment is usually mentioned as one of the primary problems with consuming ICS as the means of managing asthma. Nevertheless, the identified type of medication remains one of the most efficient means of sustaining the patient’s condition at the necessary level and preventing the disease from progressing. Thus, it is crucial to focus on developing the medicine that could counter the negative effects of the existing asthma medications. Theophylline and leukotriene modifiers, in their turn, are also viewed as some of the most common types of medication for managing the needs of patients with asthma.
The identified drugs improve the functioning of the lungs, therefore, preventing the instances of an asthma fit. However, one must bear in mind that the specified type of drugs can be considered as mild and, therefore, should be used either at the earliest stages of asthma development or in combination with other medications. Otherwise, the chances of the specified medicine to have a tangible effect on the patient are rather low. The specified type of medicine is consumed orally. Furthermore, the dosage depends on the age, weight, and other characteristics of the patient. For instance, the children under 5 are typically provided with a significantly lower amount of medicine than those aged 5-12. Teenagers, in their turn, are provided with a slightly greater amount of the medicine to address the symptoms and reduce them accordingly.
However, the medications listed above are typically referred to as the ones aimed at achieving long-term effects. In other words, they do not help address the instances of asthma attacks, in which the patient requires an immediate and fast relief. For these purposes, one must consider using Albuterol and Ipratropium (Atrovent). The identified medications are typically packaged as inhalers so that they could be easily applied when needed and that the patient could have easy access to them at any time. Despite the fact that cough and dry mouth are often viewed among some of the most common side effects, the medicine is, nonetheless, viewed as one of the most efficient means of managing an asthma attack due to its ability to relax airways. As a result, the latter do not get tighter as the asthma attack approaches, which means that the patient does not face the threat of suffocating anymore. In other words, it is desirable that a combination of metered-dose inhalers as an immediate solution for a breathing problem that the patient may have at any point and the medicine that supposedly has a long-term effect on the patient and, therefore, creates premises for reducing the number of asthma attacks.
Non-pharmacologic Treatment
Apart from the pharmacologic approach, asthma is also addressed with the help of changing the environment in which the patient lives. The factors that trigger the reaction are removed from the area. For instance, the sources of dust, such as stuffed toys, should be removed. Furthermore, the patient should avoid a contact with animals. The areas where mold is likely to grow must undergo thorough cleaning with detergents so that the mold could be removed successfully. It should be noted, though, that the identified approach is less reliable than the pharmacologic one since eliminating every single factor that may trigger an allergic reaction is impossible. Therefore, a combination of pharmacologic and non-pharmacologic tools must be viewed as the optimum choice.
Choice of the Treatment Option: Why None of the Approaches Must Be Considered Superior to Others
As stressed above, there is a consistent need in not only sustaining the patient’s current condition to prevent any aggravations but also addressing the sudden inflammations of airways that the patient may develop at any point in time due to the actors that can hardly be controlled (e.g.;, the presence of pollen in the air, the lack of humidity, etc.). Therefore, choosing one type of treatment to another does not seem sensible. Instead, a combined approach must be developed.
As far as the choice of medication is concerned, though, one must agree that some of the substances that have been promoted as the most common type of treatment have clearly worn out their welcome. Because of the numerous side effects that they are likely to entail they can be viewed as not only lacking in efficacy but also downright harmful to the patient’s well-being, Thus, the current approach toward prescribing medications to the target audience needs to be reconsidered.
Furthermore, it is important to address the specific factors that are inherent to the patient and, therefore, require adopting a patient-centered approach. For instance, in case one is physically incapable of using small inhalers, the application of nebulizers must be viewed as a necessity. For instance, nebulizers can be prescribed as the possible tool for managing asthma attacks in young patients (e.g., infants), as well as patients with disabilities that do not allow them to use the traditional inhalers. Therefore, the use of nebulizers must be viewed as one of the common instances in managing the asthma-associated issues.
Furthermore, the choice of the appropriate treatment strategy hinges on the intensity of the attacks to a considerable degree. In the scenarios that involve numerous complications triggered by the asthma attacks, a therapist may consider the use of Prednisone and similar substances as an obvious necessity. Other types of oral corticosteroids are also considered acceptable in the specified situation; aimed at managing severe outcomes quickly, the identified type of medicine has serious side effects, though. Therefore, the patient must not abuse Prednisone and other corticosteroids as the means of managing a sudden and intense asthma attack.
When defining the problems of the contemporary treatment approach and the factors that prevent from creating the medicine that will help eradicate any symptoms of asthma, one must mention the fact that the medicine will have to remove both short- and long-term effects. Seeing that the two manifest themselves in entirely different ways, creating the cure does not seem a possibility at present. To handle the problem completely, one will have to come up with the treatment that will incorporate the properties of an inhibitor and the tool for preventing chronic symptoms, such as shortness of breath.
Conclusion: Managing Asthma and Preventing the Disease Successfully: What Healthcare Services Can Do
Asthma is currently an incurable disease, and its symptoms can only be reduced in patients without eliminating them completely. Consequently, there is a significant field of work to be covered by future researchers so that the issue could be addressed successfully. More importantly, the actual factors that contribute to the development of the disease in patients have not been identified yet. Thus, it is crucial to focus on promoting further extensive studies that will serve as the foundation for the identification of asthma causes.
Nonetheless, the treatment options that have been designed so far serve their purpose quite satisfactory. The available opportunities for managing asthma and preventing its exacerbations can be deemed as rather promising. Specifically, the fact that there are two primary categories of drugs, i.e., the ones that are supposed to address the emerging problems immediately, and the ones that serve a long-term purpose,, can be considered an important characteristic of the overall strategy that is currently used to meet the needs of people with asthma. Furthermore, the fact that the needs of people with disabilities, as well as very young children, are taken into account by suggesting the medicine that will not require specific skills, such as the use of inhalers, must be brought up as an important advance in the contemporary approach toward managing asthma-related issues.
Nevertheless, the fact that the disease remains incurable clearly is a problem. Developing the framework serving as the foil for creating the medicine that will help eliminate asthma and the associated diseases must be viewed as the course for the further research in the identified area. Even though the disease is currently viewed as chronic one, there may be the solution that will help adders the associated issues. By focusing on creating the device that will embrace all objectives, including the management of the chronic issue and the provision of a short-term relief, one is likely to build the foundation for an efficient asthma medication.
References
Azalim, S. P., Camargos, P., Alves, A. L., Senna, M. E. B., Sakurai, E., & Keller, W. S. (2014). Exposure to environmental factors and relationship to allergic rhinitis and/or asthma. Annals of Agricultural and Environmental Medicine, 21(1), 59-63.
Centers for Disease Control and Prevention. (2016). Asthma surveillance data.
National Heart, Lung, and Blood Institute. (2014). What are the signs and symptoms of asthma?
O’Neill, S., Sweeney, J., Patterson, C. C., Menzies-Gow, A., Niven, R., Mansur, A. H.,… & Heaney, L. G. (2013). The cost of treating severe refractory asthma in the UK: an economic analysis from the British Thoracic Society Difficult Asthma Registry. Thorax, 70(4), 376-378.
Rambabu, B., Chandran, C. N. M., Prasad, A. K., Manikyamba, & Kumari, A. (2016). Study of prevalence and risk factors of bronchial asthma in school children in urban and rural areas of Kakinada. Journal of Evolution of Medical and Dental Sciences, 5(21), 1096-1099.
U.S. National Library of Medicine. (2016). Asthma. Web.
World Health Organization. (2014). The global asthma report. Web.