The aim of the assignment is to demonstrate the role of the Advanced Nurse Practitioner (ANP) when assessing and analysing the health needs of a specific population. The author will focus on one specific disease, Chronic Obstructive Pulmonary Disease (COPD) in relation to South Asian men living in both the United Kingdom (UK) and in South Asia. In view of the large demographics of South Asia the author will specifically focus on Indian, Pakistan and Bangladeshi groups also making a comparison with the population residing in Ireland. The author will provide a critical and analytical discussion of the key findings in relation to the defined population demonstrating how the ANP role can take these findings forward to inform current practice and initiate the development and planning of a new service to meet specific health needs. Firstly, an overview will be provided on the financial burden COPD is currently having on the National Health Service (NHS). This will be followed by a critical discussion of COPD, detrimental factors and the impact on the South Asian population.
COPD is a growing concern worldwide and in the United Kingdom (UK) (Fletcher et al, 2010). COPD is a slow developing lung disease involving the airways, leading to gradual loss of lung function (NICE, 2010). COPD is the leading cause of mortality worldwide (Calverley and Walker, 2003) and projected to be the UK fifth leading cause of death and the second highest cause of emergency admission to hospital (Department of Health, 2005).
There are an estimated 4.8% of COPD cases in the UK, although only an estimated 1.5% of the population are correctly diagnosed (Stang et al, 2009). It’s estimated that 30,000 people a year die from COPD and 1.4% of the population consult their General Practitioner (GP) each year (Murray and Lopez, 2008).
Cost varies to treat COPD dependent on the severity of the disease; mild COPD costs £149 whereby treating severe COPD can cost up to ten times as much at £1037 (British Lung Foundation, 2009). The prevalence of COPD is set to continue rising at alarming rates (British Lung Foundation, 2009). This is predominately due to the lack of awareness of the disease (British Lung Foundation, 2007). A survey by the British Lung Foundation (2007) concluded that 89% of people in the UK and 85% of smokers had never heard of COPD. An audit of 80,000 COPD admissions showed that 70% of patients had not previously admitted with the condition (Luis, Soljak and Meade, 2007). The current unawareness of the condition is leading to inappropriate hospital admissions and contributing to the significant strain on the NHS with a financial estimate costing £500 million per year (British Thoracic Society, 2006).
COPD usually develops in life-time smokers. It is estimated 50% of smokers develop COPD although non-smokers can also be affected by COPD (Murray and Lopez, 2008). Noxious gases, pollution, passive smoking, chronic respiratory infections and genetic susceptibility are other potential risk factors for developing COPD (Murray and Lopez, 2008).
Risk Factors that Contribute to the Prevalence of COPD
(Murray and Lopez, 2008)
The prevalence of COPD within the author’s local ward is 0.67%, which is below the national average of 1.5% (The National Service Health information Centre, 2008). It is estimated that these figures are grossly under estimated (The National Service Health information Centre, 2008). The prevalence of COPD in both South Asia and Ireland is significantly higher with figures estimated at 6.2% in South Asia and 7.2% in Ireland (Murtagh et al, 2008 and Chan-Yeung et al, 2004). However, all this data is thought to be unreliable, due to differences in disease occurrence, differences in defining COPD, cultural bias, and whether spirometry was used to confirm the diagnosis (World Health Organisation, 2011).
Due to the under-diagnosis and misdiagnosis of COPD within the author’s area a predictive modelling tool using...
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