Chronic Care: Treatment Modalities

Introduction

Chronic diseases need particular care to preserve the life quality of a patient. With timely diagnosis and relevant support therapy, people may lead a normal life. However, the patient’s participation is important since chronic illnesses usually have co-morbid conditions to consider. The patients from the case studies suffer from chronic diseases. A young girl has had asthma for 15 years. In addition, she has ADHD together with a generalized anxiety disorder. An old man has been recently diagnosed with COPD. Besides, he has CNF and hearing loss. Asthma and COPD are two illnesses affecting the respiratory tract, thus these two cases can be compared.

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Common Treatment Modalities and Models

Both asthma and COPD have various treatment modalities (Page & Barnes, 2017). They are inflammatory diseases influencing human airwaves. At present, these conditions are considered heterogeneous and often overlapping (Postma & Rabe, 2015). Thus, treatment approaches may be similar. For example, for both asthma and COPD patients with “easy” cases, a stepwise approach is recommended (Postma & Rabe, 2015). In the case of asthma, among major medications are inhaled glucocorticoids combined with bronchodilator drugs (mainly short-acting beta-agonists and long-acting beta-agonists (LABAs) (Postma & Rabe, 2015).

The cases of severe allergic asthma with corresponding IgE levels, anti-IgE treatment is an approved option; “long-acting muscarinic antagonists (LAMAs) have been shown to work in controlled trials and are now included in the treatment of severe asthma but are not approved by the Food and Drug Administration for this use” (Postma & Rabe, 2015, 1247). The main steps to take in treating “easy” COPD include abandoning smoking together with the application of LABAs and LAMAs. As for inhaled glucocorticoids in COPD treatment, there is still no unanimous opinion and it is usually left for more severe cases (Postma & Rabe, 2015).

Necessary Considerations

In the case of chronic diseases accompanied by co-morbid conditions, particular attention should be given to the side effects of medication and the interaction of drugs. The side effects of glucocorticoids may include the growth of blood sugar level (increasing the risk of diabetes), poor calcium absorption (can cause osteoporosis), an increase in cholesterol and gastritis risk, and negatively influence the immune system (Page & Barnes, 2017).

Beta2 antagonists which are used in the treatment of both asthma and COPD may cause growing anxiety, frequent headaches, nausea, unusual nervousness, palpitations, and tremor (Page & Barnes, 2017). In the case of Tracy, it is crucial to study the possible side effects of her ADHD medications and how they interact with asthma treatment to prevent complications. As for Mr. Bale, it is important to monitor the side effects of COPD treatment since they can affect his condition of congestive heart failure. Moreover, attention should be given to geriatric syndromes if they are detected. At present, Mr. Bale does not observe any of them.

Chronic diseases with co-morbid conditions demand consideration of risk factors. For Tracy, the risk factors include the medicine that she takes for ADHD and anxiety disorder since in combination with asthma therapy they can cause addiction and lack of ability to cope with some conditions. The first sign of the problem is the fact that she has been requesting refills for her ADHD medication prior to the due date. In case of Mr. Bale one of the dangerous factors is smoking which he was supposed to stop since he needs oxygen therapy. In addition, his inclination to cultural “home remedies” can be a risk because the interactions of traditional medicine and folk treatments are not studied.

Technological Aid

There is a variety of technical solutions to help patients cope with chronic diseases. For example, The Journal of Allergy and Clinical Immunology: In Practice (as cited in American Academy of Allergy and Immunology, 2016, para.2) states that patients who apply the Propeller Health Asthma Management Platform use less SABA. This platform has special “sensors, mobile applications, and analytics to provide self-management and physician directed care to improve asthma symptoms and asthma control” (American Academy of Allergy and Immunology, 2016, para.2).

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This platform can be useful for Tracy because of her co-morbid conditions and the irregular use of medicine. Health information technologies (HIT) also include “symptom diaries and instructions on medication usage, are associated with better disease control, enhanced quality of life and fewer hospital visits (Himes & Weitzman, 2016, p.2). Those HITs can be used by both patients from cases under analysis. Tracy can be more interested in mobile health apps, while Mr. Bale may need some assistance from his family to use the applications.

Ethical Issues

Ethical issues are common components of health care cases. As for Tracy, one of the concerns includes her requests for her ADHD medication refill sooner than it was supposed. There are two obvious solutions. One is to contact her parents and inform them of the problem. The other way out is to consult a girl on the possible consequences of drug addiction. The second solution looks more appropriate because the patient is not a child and can understand the results of her actions. In case of Mr. Bale, the ethical dilemma appears for the family of the patient. They are aware that the man does not follow the doctor’s directions to cease smoking and uses “home medicine” which may negatively influence the treatment process. The solutions include informing or not informing the physician of the violation of prescriptions. The proper choice is to inform since the concealing of such information may have negatively influence the patient.

Conclusions

On the whole, the chronic diseases are challenging both for doctors and patients. Since there is no possibility to cure the disease, the focus should be made on the reduction of the unpleasant symptoms. It can be possible only in cooperation of a health care facility, a patient, and his family.

References

American Academy of Allergy and Immunology. (2016). Improving asthma with smart technology

Himes, B.E., & Weitzman, E.R. (2016). Innovations in health information technologies for chronic pulmonary diseases. Respiratory Research, 1-7. doi: 10.1186/s12931-016-0354-3

Page, C.P., & Barnes, P.J. (Eds.). (2017). Pharmacology and therapeutics of asthma. Cham, Switzerland: Springer.

Postma, D.S., & Rabe, K.F. (2015). The asthma – COPD overlap syndrome. The New England Journal of Medicine, 373(13), 1241-1249.

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StudyCorgi. (2021, March 11). Chronic Care: Treatment Modalities. Retrieved from https://studycorgi.com/chronic-care-treatment-modalities/

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