Management of long term conditions
This assignment will reflect on an aspect of care in the management of asthma as a long term condition in the primary care setting. It will specifically focus on patient compliance and how it affects good asthma control. A case study of a 22 year old female patient who suffers from asthma will be used to explore the significance of compliance in the management of asthma and the benefits it can have to patient outcomes. The discussion will include areas relating to patient education, medication management and National Health Service strategies in asthma management. Also the role of the general practice nurse will be analysed in determining care delivery through assessment, planning and evaluation of patient outcomes. To help in the reflection process Gibb’s reflective cycle (Gibbs 1988) will be used. To respect confidentiality in accordance with the Nursing and Midwifery council (2004) the patient’s name has been changed and will be referred to as Ali.
Asthma is part of a group of conditions which include, but is not limited to, COPD, depression, diabetes and cardio vascular disease, all of which are referred to as long term conditions. A long term condition (LTC) can be defined as a condition which cannot be cured but can be controlled by medication or other therapies (DH 2013). The Department of Health that 15 million people in England suffer from long term conditions and that it accounts for 70% of the money spent on health and social care. These conditions can have a significant impact on an individual’s life in a number of ways which not only impacts the physical health of the individual but also the way they are able to live their lives. Carrier (2009) states that with acute disease the aim of the treatment is to return the person to a normal healthy state but with a chronic long term condition the patient’s life is irreversibly changed, and possibly that of their families too. This can cause additional problems such as isolation, financial loss, low self esteem and depression. Therefore by attempting to optimise the physical health of people living with a long term conditions it may be possible to improve the negative impact on other areas of their life. This not only has a positive effect for the patient but also has a positive effect on cost implications to the National Health Service (NHS) as a whole.
According to the British Thoracic Society (2009),asthma is a common condition which is estimated to affect 300 million people worldwide and more than 5 million people in the United Kingdom Evans & Tippins (2007) define asthma as a common long term condition of the upper respiratory tract which is prone to acute exacerbations in response to hypersensitivity reactions triggered by a stimulus. The reaction to stimulus, or antigens, causes the airways to become inflamed which leads to constriction. The triggers for an exacerbation of asthma can include animal, mites, cold weather, viral infections and chemicals. The signs and symptoms of asthma include wheezing on inspiration, shortness of breath, a tight chest and a cough. It is commonly treated with bronchodilators and anti-inflammatory drugs which can have a positive outcome if managed appropriately.
The Royal College of Physicians (RCP 2003)have stated that the management of asthma can be effectively undertaken in the primary care setting. However, the care needs to be delivered in a structured proactive way to achieve the best results, and if done correctly, can significantly reduce exacerbation rates and days lost from normal activity. In the general practice setting this role has increasingly been undertaken by the general practice nurse (GPN) by way of an annual asthma review. The GPN is in an ideal position to plan, implement and monitor care of the asthma patient, however, it needs to be recognised that the best laid plans will fail if there is little co-operation from the patient who will need...
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