Asthma: Epidemiological Analysis and Care Plan

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Table of Contents

Introduction
Background and Significance
Surveillance and Reporting
Epidemiological Analysis
Screening and Guidelines
Plan: Integrating Evidence
Conclusion
References

Introduction

Asthma is an illness that disproportionately affects many adults and children globally. In 2019, 262 million people had asthma, causing 461 000 deaths (WHO, 2020). Scholars have done asthma-related research to provide information on causes, symptoms, therapies, and asthma mitigation. This study will describe asthma as a chronic condition, including its symptoms and signs, incidences, surveillance, reporting, epidemiological analysis, screening, prevention, and prevalence by state and national statistics.

Background and Significance

Asthma is a lung disorder that makes it hard to breathe occasionally. Many people experience symptoms during childhood, though they can occur at any age. Asthma is caused by inflammation and subsequent muscular tightening around the narrow airways in the lungs, causing further narrowing of these passageways, leading to symptoms such as wheezing, coughing, chest tightness, and difficulty breathing (He et al., 2020). These symptoms and signs come and go and tend to be more intense at night or when exercising. Symptoms might be worsened by a variety of other typical triggers, including virus infections, weather fluctuations, fumes, smoke, dust, animal feathers and fur, tree and grass pollen, perfumes, and harsh soaps. Asthma has a variety of symptoms and pathogenesis, including acute, subacute, or chronic inflammation of the airways, intermittent blockage of airflow, and hyperresponsiveness of the bronchi (Sullivan et al., 2016). Mucus secretion and airway edema can lead to airflow restriction and bronchial reactivity (Sullivan et al., 2016). Mucus hypersecretion, epithelial desquamation, smooth muscle hyperplasia, airway remodeling, and mononuclear cells and eosinophils are all varying degrees.

Asthma prevalence has been shown to vary under various factors. It is higher in girls at 6.0% than in boys at 5.7% in the U.S., where it impacts more than 25 million people, including 8.4% of adults and 5.8% of children (CDC, 2020). There are 10.4% of women and 6.2% of males with asthma (CDC, 2020). Prevalence is higher among African Americans at 11.6% than Whites at 9.3% and lowest among Hispanics at 6.7% (CDC, 2017). In 2020, the CDC found that 7.4% of Texan adults and 7% of youngsters were currently dealing with asthma. Approximately ten individuals in the United States die every day from the illness (CDC, 2020). There were 232 fatalities in Texas in 2018, representing an annual mortality rate of 8.3 per 1,000,000 residents (CDC, 2019). The table below describes the CDC’s data about asthma prevalence in Texas and the United States.

Table 1: Prevalence Of Asthma In the U.S. & Texas

Participants	United States	Texas
Adults	8.4%	7.4%
Children	5.8%	7%

Surveillance and Reporting

Information gathered through public health monitoring is used to inform and improve programs and policies to reduce disease incidence and mortality rates. Surveillance information on the prevalence of asthma in the United States is compiled from various sources, including the Behavioral Risk Factor Surveillance System (BRFSS) and the National Health Interview Survey (Pickens et al., 2018). The local burden of asthma has been estimated in several states and towns using surveys or administrative data, including Medicaid claims data and hospitalization (Benka-Coker, 2018). All these are accurate and credible sources of surveillance data and reports.

Cases of asthma have been identified using administrative data such as outpatient, pharmaceutical, or hospital billing data. Prevalence monitoring in schools has shown to be a fruitful exercise as most children are evaluated by school-based surveillance systems because they are present at school (Benka-Coker, 2018). In the U.S., laboratories and healthcare professionals report cases of communicable disease to state or local health centers as part of the country’s primary public health surveillance system, which relies on a passive, notifiable disease monitoring system (Haghiri et al., 2019). Compared to systems that rely on administrative data, this method often provides a timelier response and can facilitate the reporting of instances or clusters of cases.

Occupational asthma has prompted the creation of the Sentinel Event Notification System for Occupational Risks (SENSOR), which functions similarly to a system for reporting communicable diseases. It is currently conducted in ten states and includes a team of sentinel healthcare practitioners who are likely to meet an instance of occupational asthma reporting specified health events (Moloney, 2022). The results of SENSOR have led to the discovery of additional triggers for asthma in the workplace, but it does not collect data on the incidences of asthma in children or adult-onset asthma unrelated to work (Moloney, 2022). The SENSOR system offers helpful data on the prevalence of asthma in the workplace.

Epidemiological Analysis

This section focuses on asthma – a chronic disease (What) that seriously affects children and adults (Who). Some of the most extensive asthma statistics come from high-income countries (Where) like the UK, Canada, Germany, New Zealand, and Australia, with severe asthma having a prevalence of 2-10% for the years 2017-2020 (When) (Stern et al., 2020). An estimated 23.4 million people have asthma, including 7 million children (Batra, 2022). If those without asthma are not counted, the prevalence of exercise-induced bronchial asthma is between 3 and 10%; if individuals with chronic asthma are included, it rises to 15% (Dharmage et al., 2019). Asthma morbidity and its prevalence appear to be on the rise, especially among children younger than six (Stothers, 2022). Interestingly, about two-thirds of those with asthma have their condition identified before they turn 18 (Stern et al., 2020). Therefore, prevalence changes with the country, sex, and even age.

Various factors contribute to developing asthmatic symptoms at any age (Why). While heredity plays a significant part in predicting susceptibility to developing asthma, environmental factors, rather than race, contribute more significantly to the disease (Dharmage et al., 2019). Air pollution, urbanization, passive smoking, and shifts in exposure to environmental allergens are among the factors that have been suggested as causes (Stothers, 2022). Most children with asthma see improvement or complete resolution of their condition by the time they are young adults because airway reactivity and poorer pulmonary function levels contribute to higher asthma rates in young patients (Stern et al., 2020). Hence, prevalence is higher among children than adults because most of the young ones will recover.

Asthma costs can be broken down into two categories: direct costs and indirect costs. Expenses considered “direct” are associated with hospital stays, doctor visits, nurses, ambulance rides, prescriptions, lab work, diagnostics, and preventative measures (Nunes et al., 2017). The costs associated with morbidity cannot be directly measured, such as the time and energy a parent or caregiver invests in caring for an asthmatic kid. Expenditures on prescription drugs and hospital stay accounted for the bulk of direct medical costs, significantly higher than indirect costs (Nunes et al., 2017). Direct medical expenditures may rise, but the total cost of treatment may go down if indirect costs fall by an even more significant amount due to better clinical outcomes.

Screening and Guidelines

Diagnosis begins with a discussion between the patient and the doctor regarding symptoms and general health. The doctor asks about existing symptoms and any possible triggers. The doctor carries out different types of screening, including spirometry, challenge tests, lung tests in children, and exhaled nitric oxide tests (Saglani & Menzie, 2019). For patients aged five years and above, spirometry is the standard diagnostic procedure that evaluates the inhaling and exhalation volumes and air rates (Louis et al., 2022). Asthma causes airway narrowing, so if the patient’s vital signs are below average for someone of the patient’s age, it may indicate that the patient needs medical attention. If the patient has asthma, the doctor may request that the patient inhale a medication to relax the patient’s airways before repeating a lung function test (Louis et al., 2022). Signs of marked improvement after this treatment suggest the possibility of asthma.

Since spirometry is a rather effective diagnostic tool, it is essential to analyze some of its characteristics. Thus, the research by Meneghini et al. (2017) showed that “the specificity of spirometric abnormality for detecting asthma was 90%, sensitivity was 23%, positive predictive value was 22%, and negative predictive value was 91%” (p. 428). These findings show that this test can be used only in specific cases like screening workers exposed to pollutants, but for most patients, this test is not enough because of its low sensitivity. However, since spirometry has a high NPV, it is likely that when the test is negative, a patient does not have asthma. Noticeably, spirometry shows higher levels of specificity than some other tools. Overall, spirometry is relatively cheap and rather common (Aaron et al., 2018). Patients not diagnosed using spirometry have higher overall costs than those who use this method.

The American Thoracic Society (ATS) and the European Respiratory Society (ERS) have published a standardized spirometry protocol. One indicator of airway obstruction is the fraction of one second’s forced expiratory volume divided by one’s forced vital capacity (FEV1/FVC) (Graham et al., 2019). Asthma is characterized by reversible physiological airflow restriction and airway diameter changes; spirometry should be the first step in the diagnostic process.

Plan: Integrating Evidence

To control asthma, it is important to uncover and discuss its primary, secondary, and tertiary interventions that can be used by a nurse practitioner after graduation. The primary intervention is to position the patient properly, check the vital signs, and administer bronchodilators and oxygen if needed (Issel et al., 2021). These methods will help the nurse mitigate the asthma attack. Then, for the secondary intervention, the medical worker should use long-term control drugs like inhaled corticosteroids, prednisone, and budesonide (Sobieraj et al., 2018). These preventative asthma drugs target the inflammation of the airways, which is the root cause of asthma symptoms.

Finally, the education of patients is the tertiary method a nurse has to implement. Asthma interventions targeting teenagers and children must be customized to their specific conditions. Teens and kids in rural areas are more likely to benefit from interventions that include school-based health education programs and nurse services for asthma treatment (Horner et al., 2016). Rural children’s asthma outcomes are most likely to improve from interventions that go beyond encouraging strict adherence to prescribed medications. Positive results have been seen from interventions that boost healthcare providers’ understanding of asthma and its treatment (Estrada & Ownby, 2017). Programs with the most effects have trained primary care physicians and school nurses to better educate their patients about asthma and its management.

In order to ensure that the interventions have utility and that they are useful, I will incorporate their key aspects and components when treating the patients (Issel et al., 2021). I will also identify the patients that benefit from each type of intervention. I will also record and analyze specific conditions under which each intervention achieves maximum results (Issel et al., 2021). It will be possible to integrate health policy advocacy efforts, namely, the creation of school-based preventive programs to reduce the number of accidents among children.

Conclusion

In conclusion, the paper has discussed vital issues relating to asthma by collecting and interpreting data from previous research sources. The report has described and defined critical terms related to asthma, provided a background review, and discussed its signs and symptoms. The symptoms and signs identified are breathing difficulty, coughing, chest tightness, and wheezing (He et al., 2020). The paper has also discussed numerous approaches to monitor and survey disease prevalence, such as primary public health and sentinel surveillance system (Moloney, 2022). Epidemiological analysis, screening, and guidelines associated with asthma have also been discussed. Since statistics show that over 20 million people have asthma in America, this is a rather serious public health issue (Batra, 2022). Finally, the paper has provided a plan discussing the key interventions that can be incorporated to mitigate asthma. The interventions discussed are providing health care education, quick-relief efforts, and long-term asthma medications (Sobieraj et al., 2018). Healthcare education provided in schools also ensure that children and teenage cases are properly managed.

References

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Batra, M., Vicendese, D., Newbigin, E., Lambert, K. A., Tang, M., Abramson, M. J., & Erbas, B. (2022). The association between outdoor allergens–pollen, fungal spore season, and high asthma admission days in children and adolescents.International Journal of Environmental Health Research, 32(6), 1393-1402. Web.

Benka-Coker, W. O., Gale, S. L., Brandt, S. J., Balmes, J. R., & Magzamen, S. (2018). Optimizing community-level surveillance data for pediatric asthma management. Preventive Medicine Reports, 10, 55-61. Web.

Centers for Disease Control and Prevention (CDC). (2020). Most recent national asthma data. Web.

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Centers for Disease Control and Prevention (CDC). (2017). Adult asthma data: BRFSS prevalence tables and maps. Web.

Dharmage, S. C., Perret, J. L., & Custovic, A. (2019). Epidemiology of asthma in children and adults.Frontiers in Pediatrics, 7, 246. Web.

Estrada, R. D., & Ownby, D. R. (2017). Rural asthma: Current understanding of the prevalence, patterns, and interventions for children and adolescents.Current Allergy and Asthma Reports, 17(6), 1-8. Web.

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Issel, L. M., Wells, R., & Williams, M. (2021). Health Program Planning and Evaluation: A Practical Systematic Approach to Community Health. Jones & Bartlett Learning.

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Meneghini, A. C., Paulino, A. C. B., Pereira, L. P., & Vianna, E. O. (2017). Accuracy of spirometry for detection of asthma: A cross-sectional study.Sao Paulo Medical Journal, 135, 428-433. Web.

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Pickens, C. M., Pierannunzi, C., Garvin, W., & Town, M. (2018). Surveillance for certain health behaviors and conditions among states and selected local areas—behavioral risk factor surveillance system, United States, 2015. MMWR Surveillance Summaries, 67(9), 1. Web.

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