Home and community-based care is an approach to care provision that combines clinical services, nursing care, and social support. It refers to the continuum of care extended to patients from the health facility to the community and homes. Asthma is a persistent respiratory disease with intermitted symptoms. The bronchioles produce mucus when subjected to allergens which obstruct airflow. The etiology of asthma is unknown but improvements to ensure a healthy environment and adherence to medication can increase medical outcomes.
Community interventions should provide patients with an efficient and supportive environment that helps them to manage their own asthma and respond to emergencies. The first step in establishing effective community intervention involves the identification of all those patients whose physicians have diagnosed them with asthma. These patients should be encouraged to join support groups. Health care providers can easily monitor their progress. Clients can be trained on how to manage asthma from the community level. Doctors should issue patients with a written ‘Asthma Action Plan” which details information on daily treatment and symptoms of worsening asthma (Clark, Mitchell & Rand, 2009, par. 2-4). Referral linkages between the community and health facilities can be established. The American Lung Association provides immediate access to medications, medical providers as well as mitigation measures to complications. Clinicians can carry out outreach to patients within the community. Another approach would be to use community health workers to provide asthma education to patients and their families. This would include modifying environmental factors such as pest control. An asthma attack is fatal and patients should be encouraged to perform self-administration of medication (Asthma Education, n.d, p. 104).
Various drugs can be used to reduce the effects of asthma. According to (“National guidelines on clinical diagnosis and management of asthma, 2007 pp. 215”) Asthma medications are classified into two: long term medications, taken daily to achieve and maintain persistent control of asthma and quick-relief medications taken to promote prompt reversal of acute airflow obstruction and relief of accompanying bronchoconstriction. Aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) increase the effects of Asthma. Albuterol relaxes bronchial smooth muscles by action on beta2 receptors, with little effect on cardiac muscle contractility. The intensity of treatment varies with the severity of symptoms. All patients with Asthma should be advised to avoid allergens, foods rich in sulfites and caffeine if they are sensitive. Caffeine increases the stimulant effect of bronchodilators. Patients need to avoid environmental allergens such as smoke, cockroach dust and pollen (National Asthma Education and Prevention Programme Expert Panel Report 3, 2007, pp. 3-5)
It is important to treat asthma symptoms when they first appear; this helps in preventing them from worsening. This can cause an Asthma attack which requires emergency care or even death. Patients should seek medical advice if they present with the following signs: heart palpitations, dizziness, diaphoresis, or chest pain. The client should first use Albuterol before using other inhalation medications and allow for a break of about five minutes before administration of drugs. Clients should be encouraged to comply with treatment and not to overdose. Excessive asthma anxiety can affect the patient’s response to asthma attack; affect the quality of life as well as compliance to treatment. Behavioral therapeutic programs, as well as provider-initiated counseling, can greatly reduce anxiety in asthma patients. Community-based programs should integrate asthma control activities into existing systems such as schools, child care, youth programs, workplaces, primary health, and job training programs.
Reference list
Asthma Education, (n.d). Maximizing school Health Services. American Lung Association.
National Asthma Education and prevention Programme Expert Panel Report 3 (EPR3) (2007). Clinical diagnosis of asthma: Guidelines for the Diagnosis and Management of Asthma. Web.
Clark N., Mitchell H, and Rand C., (2009). Effectiveness of Educational and behavioral Asthma Interventions. Pediatrics 123 (supliment_3):S185-S192. Web.
Asthma is a respiratory condition that causes the airways to be blocked, leading to wheezing and difficulty in breathing. Generally, mild asthma has minor consequences on daily activities and does not pose a major health concern. However, severe asthma characterized by repeated attacks may be life threatening. It, therefore, calls for urgent medical care to be provided. It may also lead to hospitalization and death in some rare cases (Basch, 2011). Basch (2011) reports that minority youth in poor urban setups experience high rates of severe asthma. This group of youth is adversely affected by the disease. Asthma impacts negatively on their quality of life, together with their families. To a large extent, asthma in the minority youth is associated with ineffective and insufficient utilization of health care services and resources. It lowers the psychological, emotional, and their physical health state, thereby causing harmful and negative effects on their educational results. Most adolescents suffering from asthma, specifically those with severe cases, suffer from depression, anxiety, and low self-esteem. Also, adherence to treatment is poor among asthmatic adolescents, with the rate of adherence compared to controller medication being as low as 25% (Rohan, 2010).
Asthma in children
Asthma is classified as among the commonest respiratory conditions of a chronic nature in children in the US. Akinbami, Moorman and Liu (2011) reported that the prevalence of asthma in 2009 had reached its highest ever at 9.6 percent. Children who suffer from asthma have a high morbidity rate, in addition to a generally reduced quality of life because they are less playful and they miss a lot of school days. They also visit hospitals for treatment often. For example, Basch (2011) reported that children together with adolescents had 64, 0000 emergency hospital visits and approximately 10.5 million did not attend school due to asthma between 2005 and 2007.
The prevalence of asthma varies with different ethnic communities. American Indians, Blacks, and Alaska Natives have a higher prevalence compared to White American children (Basch, 2011). It is reported that asthma emergencies are more common among the blacks than the whites. This is the same case with hospitalization and ED visits for asthma among the children of non-white American youth. This shows that the non-whites bear a bigger asthma burden than the white youth.
Objectives of Healthy People 2020 seek to, “Attain high-quality, longer lives free of preventable diseases, disabilities, injury and premature death while promoting quality of life, healthy development and healthy behaviors across all life ages” (Akinbami, Moorman, Garbe, & Sondik, 2009, p. 132). Several measures have been put in place to control asthma based on these objectives. Basch (2011) indicates that it is now possible to manage asthma with a lot of effectiveness due to the intense research on how to handle the disease and its effects. Asthma is basically controlled through medication for addressing the clinical symptoms, keeping away from triggers of asthma, and providing access to quality care. Unfortunately, youth from poor minority backgrounds are not in a position to access these amenities. Lack of the intervention strategies causes most of these poor youth to have frequent visits to the emergency departments.
The control and prevention of adverse effects of asthma are goals of managing asthma as stated in the National Asthma Education and Preventive Program (NAEPP) asthma treatment guidelines (Basch, 2011). The main management strategy for asthma as stated in this program is the Preventive Asthma Medication (PAM). Any substance or condition that triggers asthma should be avoided. Moreover, asthma management should be taught to the patients and their caretakers. However, more research has shown that proper management of asthma can be achieved if emphasis is put on youth who are known to have asthma, rather than the whole community at large (Kathleen 2011). Developing strategies that target schools will be more effective and appropriate in fighting the asthma menace, given most youths in this category attend school. There are several strategies that have been proposed by the CDC as effective means of managing asthma (Basch, 2011). These strategies can be employed by schools at an individual level or at the district level.
As reported by Basch (2011), one of the most critical approaches in achieving this goal is establishing support and management systems that will guarantee asthma friendly schooling environments. The systems may implement guiding and counseling measures to foster positive living among students with asthma. Social discrimination that may arise as a result of the vice from other students should also be taken care of in full by these systems.
Asthmatic students should be provided with health services that address their asthmatic conditions as a strategy of managing asthma. A closer association between school administrations and the students is vital in achieving the mental stability of these patients. This measure will definitely ensure improved performance of such students as mental stability leads to better academic performance, thereby reducing the academic gap that exists between victims and healthy individuals.
Asthma attacks are not limited to children, but they also have serious implications on adults. Statistics show that currently, more adults are affected by the disease than children. A report by Akinbami, Jeanne and Xiang (2011) showed that the prevalence of asthma was 8.2% in 2009. About 17.5 million of those affected are adults compared to 7.1 million children who are between 0-17 years of age. The prevalence of asthma attack was estimated to be 4.2%, representing a population of 12.8 million Americans. About 8.7 million of these were adults, while children were 4.0 million. These statistics mean that among those currently affected by asthma, 52% had asthma attacks and are at a high risk of developing adverse effects, like hospitalization and/or emergency department visits (Akinbami, Jeanne & Xiang, 2011).
Asthma and Adults
Asthma has resulted in absenteeism at work for adults, or at least it has resulted in activity limitation. Akinbami, Jeanne and Xiang (2011) reported that up to 14.2 million Americans miss a number of working days in a span of 12 months due to asthmatic attacks and related symptoms. Asthma patients experience activity limitation in the form of the inability or reduced ability to execute normal duties that one would, otherwise, do with ease at their age. Akinbami, Jeanne and Xiang (2011) describe that about 6 percent of the employed persons with asthma experience activity limitation associated with breathing difficulties. Among the unemployed, those who had an asthma attack within the last 12 month had missed work within the compound or around the house. Akinbami, Jeanne, and Xiang (2011) reported that 22 million workdays of housework with other activities were missed, while 27% reported to have had an activity limitation due to a breathing problem. Annually, it costs about 18 billion to the economy of the US to address asthma cases (Shenolikar, Song, Anderson, Chu, & Cantrell, 2011).
Even in adults, scanty information is available on how to prevent the development of asthma in individuals. Managing asthma in adult is only effective when a preventive approach is taken, rather than trying to treat the disease (McDonough & Mault 2013). Drug therapy for asthma relieves the symptoms of the attacks temporarily. However, prophylaxis helps in reducing the rate of asthma episodes. It is also important to monitor the patient closely to help curb the symptoms associated with asthma early enough. Avoiding allergens that trigger asthma, such as smoke and dust, goes a long way in preventing asthmatic attacks (Akinbami, Jeanne & Xiang, 2011).
Asthma and Memphis Tennessee area
The Memphis Tennessee area is one of the regions within the United States that have a very high prevalence of asthma. A comprehensive plan needs to be established and implemented to control asthma in Memphis. Within this report, I have come up with ideas that can reduce the disease burden significantly if implemented. This basically involves creation of Self Help Groups and Community Based Organizations, all geared towards fighting and controlling asthma. Self-help groups may be mainly composed of the victims of asthma. This may create a forum for the patients to meet and discuss their experience with the disease and how each one of them has been managing it, among other things. The resolutions arrived at will be adopted and used by the rest of the group members.
Community-based organizations will basically be involved in assisting the affected patients in terms of care provision, providing medications, and creation of a favorable environment for the affected victims. Such activities may involve clearing of pollutants within the community. The organizations should also identify specific needs of each group demographically and provide the required care.
References
Akinbami, L. J., Moorman, J. E., Garbe, P. L., Sondik, E. J. (2009). Status of childhood asthma in the United States, 1980–2007. Pediatrics, 123(suppl 3), S131–S145. Web.
Akinbami, L. J., Moorman, J. E., Liu, X. (2011). Asthma prevalence, health care use, and mortality: United States, 2005–2009. National Health Statistics Reports no 32.
Basch, C. E. (2011). Asthma and the achievement gap among urban minority youth. Journal of School Health, 81, 606-613. Web.
Rohan, J., Drotar, D., McNally, K., Schluchter, M., Riekert, K., Vavrek, P., Schmidt, A., Redline, S., & Kercsmar, C. (2010). Adherence to pediatric asthma treatment in economically disadvantaged African-American children and adolescents: an application of growth curve analysis. Journal of Pediatric Psychology, 35(4), 394–404. Web.
Shenolikar, R., Song, X., Anderson, J. A., Chu, B. C., & Cantrell, C. R. (2011). Costs of asthma among US working adults. The American Journal of Managed Care, 17(6), 409-416.
Kathleen, C. (2011). Keeping asthma at bay. American Nurse Today. vol. 6, issue no. 4. Web.
McDonough, B., & Mault, S. (2013). Non-attendance at a difficult-asthma clinic. Nursing Times, 109(16), 12-14.
Asthma is an inveterate lung disease that causes inflammation and narrowing of lung airways. Due to inflammation, the airways become swollen and sensitive.
Asthma affects all people starting mostly in early childhood.
According to the Department of Health (2008), over 22 million people in the United States of America are known to have asthma. This includes 6 million children who are the most susceptible group.
Societal costs are far reaching. According to the Centre for Disease Control (2009), 40,000 people miss school or work due to asthma, 30,000 people have an asthma attack, 5,000 people visit the emergency room due to asthma, 1,000 people are admitted to the hospital due to asthma and 11 people die from asthma every day.
On economic costs, the average annual cost of care for a single patient is $4,912. 65% of this amount covers hospital admissions, medications and doctors’ visits while 35% covers indirect costs like time lost at work (The Journal of Allergy and Clinical Immunology, 2003, pg. 26).
What is Asthma?
Asthma is an inveterate lung disease that causes inflammation and narrowing of lung airways.
Due to inflammation, the airways become swollen and sensitive; therefore, they react strongly to even mild substances that the patient breathes in.
In response to these inhaled substances, the muscles surrounding the airways tighten thus causing the airways to narrow; hence, restricting the flow of air in and out of the lungs.
In severe cases, these muscles tighten further and this causes the cells around the airways to secrete excess mucus; a thick sticky liquid that narrows the airways further thus aggravating the condition.
Effects of asthma are more pronounced mostly at night and early in the morning and this results in lack of sleep.
According to Rose, Mannino and Leaderer ( 2008), asthma prevalence increased between 1980 and 1996. The prevalence then stabilized between 1997 and 2004 after which it decreased gradually until 2008 (p. 23). This data however, puts on record the reported incidences only. There is a probability that the prevalence may be higher than this considering the unreported cases.
Death rates are closely associated with the prevalence and as the prevalence increased, death rates also increased and decreased proportionally to decrease in prevalence.
Signs and Symptoms
The common signs and symptoms of asthma are:
coughing especially at night and early in the morning.
wheezing; this is a whistling sound that comes out as one breathes.
shortness of breath which is accompanied by difficulties in getting air out of lungs.
chest tightness which feels like something is squeezing the chest.
rapid breathing
retractions
blue lips, pale and sweaty face
tightening of chest and sometimes neck muscles (Chesney, 2007, p. 200).
Risk Factors
Children below the age of five years
Adults around the age of thirty years
Aged people who are over the age of sixty years
A family history of asthma
Atopic personal history
Allergies
Continued exposure to second-hand smoke
Air pollution especially in urban areas
Obesity
Relatively low vitamin D levels in the body
Smoking
Low birth weight
Exposure to chemicals especially in work place
Frequent consumption of fast foods
Sinusitis
Use of antibiotics especially in children below a year old
Those born during winter (Revicki and Weiss, 2006, p. 481-2).
Assessment
Asthma can be assessed through medical history, physical examination or laboratory tests.
On medical history, doctor enquires from the patient whether there has been any individual in that family reported to have asthma or allergy. This is followed by the patient giving detailed medical information concerning how he or she is feeling to determine symptoms of asthma. If asthma is detected at this level, the doctor can determine its severity. During this session also the doctor can establish any possibility of risk factors that the patient may have encountered. This stage is very crucial because a doctor can fail to determine infection especially in mild cases.
The doctor can carry out physical examination by listening to patients breathing to detect any signs of asthma. It is important to note that one can have asthma and still lack any visible signs; therefore, this necessitates diagnostic tests.
In diagnostic test, the doctor carries a spirometry test which establishes how the lungs are functioning. It is a test to establish how much air is breathed in and out. It also measures how fast an individual can breathe out. During these tests, doctors give some medicines and then repeats the test to see whether the primary results have improved (Revicki and Weiss, 2006, p. 485-8).
Other assessment tests includes:
allergy testing to establish the type of allergens that affect the patient.
testing the sensitivity of the airways in a test known as bronco provocation test.
testing to determine presence of other diseases that may have similar symptoms to asthma like sleep apnea and vocal chord dysfunction.
carrying out a chest x-ray to determine whether other diseases may be symptoms
Screening Guidelines
Screening processes often depend on results obtained from the assessment tests.
The most applied screening procedures include; spirometry, peak flow meter, bronchial provocation among other tests.
Spirometry is the most reliable way to screen individuals for asthma. It measures the amount of the air entering and leaving the lungs.
A spirometer is a measuring device attached to disposable mouthpiece cardboard. The patient breathes in and out deeply and after sealing his or her lips around the mouthpiece, he or she forcefully empties all the air from lungs for as long as possible. The exhalation should take at least six seconds.
If the amount of air expelled in the first second is not proportional to that exhaled in the other seconds, then the individual has an obstruction.
A patient with chronic asthma may give a normal spirometer reading; therefore, to overcome this Peak Expiratory Flow (PEF) is used to monitor reversible air obstruction. PEF test takes about two weeks as the patient records expiratory flow after waking up in the morning before taking bronchial-dilation medicines. During the day the patient has to take up to three PEF tests and record them for follow up purposes. A variability of over 20% is an indication of reversible air obstruction.
Finally, bronchial provocation can be used to determine mild airway obstruction that cannot be detected through spirometry or PEF. In this case a patient is given histamine or methacholine to trigger hyper-responsiveness. Where there is hyper responsiveness resulting to increment of over 20% of spirometry after taking histamine, there is no asthma infection.
Everyone should be screened for asthma because it is a disease that affects all people. However, emphasis should be put on children under five years and old people over 65 years of age because they are more prone to asthma than any other group. This does not mean the rest of the population should not be screened; no, it is advisable for everyone to be screened.
People should be screened for asthma at least once in two years or when one experiences difficulties in breathing (John Hopkins Medical Institutions, 2009).
Primary/tertiary non-pharmacological intervention
Primary prevention of asthma involves maintaining clean working environment. This implies keeping the environment void of pollution starting with personal cleanliness.
People should avoid exposure to known irritants or allergens by wearing protective clothing like gloves and masks (Newman, 2004, p. 35).
Avoid predisposing practices like smoking.
Tertiary non-pharmacological prevention include flu vaccination (Newman, 2004, p. 35).
Keep a regular screening habit to detect asthma as it arises.
Keep children healthy to ensure that predisposing conditions are eliminated.
Monitor one’s breathing especially after exercise or in cold weather. This is because these there are forms of asthma triggered by such conditions.
Conclusion
Asthma is a disease of the lungs which causes blockage of airways.
It is fatal but preventable and curable.
Its prevalence and incidence has been on the decrease from late nineties to date.
Common symptoms include wheezing; however, there is need to go through assessment and diagnosis to determine if one is affected.
There are different screening procedures depending on the stage of the infection. These include spirometry, peak expiratory flow and bronchial provocation.
Prevention is always better than cure; therefore, people should avoid all predisposing conditions.
References
Centre for Disease Control (2009). Asthma Facts and Figures. 56(8):16-18. Web.
Chesney, M. (2007). Magnesium’s Role in Pediatric Asthma. Air Medical Journal.
Department of Health. (2008). Adult Asthma Prevalence in the United States and New York State.
Johns Hopkins Medical Institutions (2009). Mother’s Depression a Risk Factor in Childhood Asthma Symptoms. ScienceDaily. Web.
Newman, D. (2004). Guidelines for the Prevention, Identification and Management of Occupational Asthma: Evidence Review and Recommendations. Web.
Revicki, D., & Weiss, R. (2006). Clinical Assessment of Asthma Symptom Control: Review of Current Assessment Instruments. 43(7): 481-487
Rose, D., Mannino, M., & Leaderer, P. (2006) Asthma prevalence among US adults, 1998–2000: Role of Puerto Rican ethnicity and behavioral and geographic factors. Am J Public Health. 96:880–8.
The Journal of Allergy and Clinical Immunology, 2003. Web.
Young and co-workers described Asthma and Emphysema as respiratory ailments and in many respects the symptoms overlapped. Asthma is recognized as restricted airflow through air pipes or bronchial. The restricted airway and airway edema could be due to muscular constriction of air pipes and/ or layering of sticky mucus towards inner wall. Typical asthmatic symptoms are breathlessness, wheezing, occasional exacerbations and other airway hyper-responsiveness. Allergens are the principal cause for Allergic asthma. Intrinsic asthma is independent of allergens, due to cold or exercise. Hay fever asthma can be triggered by mast cell degeneration. The early response of asthmatic attack is release of histamine, leukotrienes and prostaglandin, leading to airway constriction, blood vessel dilation and mucus buildup. Late responses involve release of interleukins, tumor necrosis factor, and platelet activating factor, resulting in adhesion of inflammatory cells – eosinophils and neutrophils towards inner bronchial tissue. Series of oxidative and toxic manifestations lead to upper respiratory tract edema, muscular hypertrophy and mucus plugging (24-30).
Emphysema affects the distal parts of air pipes, i.e. the alveolar sacs, which get clogged up due to mucus or phlegm. It is hard to clinically distinguish Asthma and Emphysema as the symptoms are largely similar, although as O2 supply to the brain reduces and CO2 concentration goes up, impaired mental ability and blue nail, skin, lips associate with emphysema (Fletcher & Pride 81-85). According to Kinsella and others, etiology of emphysema is often associated with smocking, and this led to the hypothesis that emphysema develops with age whereas asthma is mostly prevalent in children. Much of the diagnostic pulmonary functions like FEV1, FVC, TLC, and DLco etc. also can not differentiate asthma from emphysema. In computer tomography that distinguishes the images of aerated lungs from malfunctioned alveoli; quantitative difference between the two disorders can be obtained. Bronchial wall thickening and fibrosis at different peripheral pulmonary regions is associated with emphysema and not asthma. Increased level of IgE is associated with smocking and is more prevalent in emphysema patients. Another important biomarker associated with emphysema is α-1 antitrypsin deficiency, which is poor prognosis marker for asthma (286-289).
Review of historical perspective of informed consent
Scientific discoveries of the 20th centuries also led to developments in the field of medicine. Researchers have used such knowledge to develop drugs and vaccines that protect people from diseases. However, some of these drugs have resulted from research atrocities involving human subjects. Subjects in such studies rarely get any information about clinical trials. Thus, they do not give informed consents to the studies.
Horror cases from the World War II by Nazis, atrocities of the United States Public Health Service (USPHS), and other medical trials made the public demand for ethical procedures and practices in medical studies. This was the beginning of bioethics and the emergence of Institutional Review Boards (IRBs).
Informed consent aimed at protecting the research participants. People interested in taking part in research trials have the right to know risks, benefits, procedures, the aim of the study, and protection of identity (confidentiality). Thus, participants can give their consents through signing consent forms. However, subjects retain the right to withdraw from the study when they want (Aschengrau and Seage, 2007).
A serious case involving human subjects was Tuskegee experiment, which showed that withholding treatment from the research subjects was unethical. The USPHS conducted the study from 1932 to 1972 using 600 subjects who never consented to the study. This violation of subjects’ right led to the formation of the National Research Act of 1974. Before this Act, there was also the Declaration of Helsinki in 1964. This declaration became the foundation of protecting all humanities from unethical research studies. Since then, the UN has revised the document on several occasions (Pelias, 2006).
However, the introduction of IRBs, Acts, Declaration of Helsinki and other measures to protect subjects have not been effective as research standards still fail to meet ethical requirements. In some cases, subjects have lost their lives. This was the case of Ellen Roche in 2001 Asthma Study.
The role of the case of Ellen Roche (Asthma Study) in developing ethical research practices
The Office for Human Research Protections (OHRP) provides clear and detailed procedures of obtaining informed consent (Office for Human Research Protections, 1993). However, some researchers and subjects fail to adhere to such requirements leading to severe ethical issues and legal consequences.
Roche was a healthy research subject. However, the subject inhaled hexamethonium and became ill. Hexamethonium causes lung damages. This explains why researchers administered the drug in extraordinarily large amounts. Roche succumbed to lung damages in less than a month after inhaling hexamethonium.
The OHRP investigated the incident and found several violations of the subject’s rights (Savulescu and Spriggs, 2002). The IRB of Hopkins did not take precautions to protect the subjects. First, board did not review the toxic effects of inhaling drug since its ban in 1970s by FDA. These data were readily available in medical journals. Second, the IRB did not consider additional materials on safety beyond what it had. Third, the researcher failed to warn subjects about effects of inhaling the drug. Instead, he withheld information from subjects by failing to inform them that hexamethonium was under experiment (Savulescu and Spriggs, 2002). Fourth, subjects did not give informed consent due to inadequate information provided. After the experiment, the researcher failed to report emerging conditions and concluded that subjects were reacting to cold due to changes in temperatures.
The case of Roche shows flawed and ineffective systems of protecting human subjects in research. It also shows that institutions’ IRBs may have vested interest in the study. This makes them lack a true independent review of the study.
References
Aschengrau, A. and Seage, G. (2007). Essentials of Epidemiology in Public Health (2nd ed.). Burlington, MA: Jones & Bartlett Learning.
Pelias, M. K. (2006). Human Subjects, Third Parties, and Informed Consent: A Brief Historical Perspective of Developments in the United States. Community Genet, 9(2), 73-77.
Savulescu, J. and Spriggs, M. (2002). The hexamethonium asthma study and the death of a normal volunteer in research. J Med Ethics, 28(1), 3-4.
Asthma refers to a medical problem that affects the air passages of the lungs whose cause has not been established. The airways of asthmatics have been shown to be extremely sensitive. In addition, when they encounter certain triggers, they normally narrow. Consequently, the victim ends up experiencing breathing difficulties.
When the lining to the airways swell and get inflamed, this causes their narrowing. Consequently, the airway muscles become tighter, leading to excessive production of mucus. Eventually, air out and into the lungs becomes reduced. According to the Australian Bureau of Statistics (ABS) (1), the country has the highest prevalence of Asthma in the world. Estimates on the prevalence of asthma published in 2008 indicated that about ten percent (two million people) of the Australian population had reported suffering from the disease in the years 2004 to 2005.
The bureau also reports that Asthma is one of Australia’s most widespread chronic health problems. The country spent an estimated six hundred and ninety-two million dollars on the management of Asthma in the year 200-2001. Mortality due to Asthma in Australia is also very low, the number of deaths reported to be due to Asthma in 2005 accounted for only 0.2% of all the deaths recorded in the country(1).
Treatment options available in Australia
To this date, there is no precise cause or cure for Asthma. However, the condition is treatable. Currently, there are three major forms of treatments that are commonly used all over the world and which are available for Asthmatics in Australia. The first type of treatment involves the use of various medications, the second treatment strategy is avoiding triggers while the final treatment modality is integrative medicine which combines the use of complementary therapies and medications (Gershwin&Albertson) (2).
Medications
Bass (3) explains that medications used for treating asthma fall under two main classes; quick relief and controller asthma medications. Quick-relief medications are used to manage symptoms that come with acute attacks of asthma-like coughing, tightening of the chest, and difficulties in breathing. Most quick-relief medications are inhaled by the patient so that they can open the airways and enable the patient to breathe. Examples of quick-relief medication for the treatment of Asthma include short-acting Beta-2 Agonists which provide quick relief for 3-6 hours. Ventolin, Maxair, and Proventil are the commonest drugs from this class that can be found in Australia.
Inhaled steroids are examples of controller medications that have proved quite beneficial to asthmatics. These steroids are very effective in reducing airways inflammation. Examples of drugs that fall under this class include QVR, Asmanex, Flovent, and Azmacort. According to Adams (4), these drugs do not act as fast as the Beta-2 agonists and they take time for them to take effect. Due to this, they are mostly used for preventive purposes. If the Asthmatic patient uses these medications properly; there is a greater possibility of effectively reducing severe attacks in the future.
In the cases where inhaled corticosteroids have not been effective, long-acting Beta Agonists are used. Hansel and Barnes (5) explain that most long-acting Beta –Agonists are used for prophylactic treatment rather than symptomatic treatment of Asthma. They are also considered to be effective as they provide a longer duration of symptom control (about 12-24 hours). Drugs from this class are often used in combination with inhaled corticosteroids and examples include Foradil, Serevent, and Brovana. The other types of medications used in the treatment of Asthma include Leukotriene antagonists and anticholinergics. At times, different combinations can be used at the same time to make treatment more effective.
Complementary therapies
Besides the use of medication, there are numerous treatment therapies that are used at times together with the conventional medications prescribed by a doctor or a general practitioner. These complementary therapies include the use of herbs, acupuncture, Buteyko, Yoga, and breathing techniques. Murphy (6) explains that some people in Australia drink a mixer of juice from the stinging nettle with honey or sugar in order to ease bronchial congestion, hay fever, and Asthma. The Aborigines of Australia have for many years used Euphorbia hirta to manage symptoms of asthma. The plant is popular in the community and it has come to be referred to as the Asthma tree.
Deutsch and Anderson (7) have cited acupuncture as another complementary treatment technique that is used (though not frequently) in the management of chronic asthma in Australia. It is important to be aware that the National Asthma Council of Australia has not declared acupuncture to be a conventional treatment for asthma as there is little research evidence on the benefits asthma patients’ can derive from acupuncture. It is thought that patients can derive short relief from symptoms of asthma through acupuncture.
To provide asthmatic patients and health care providers with clear information on various complementary therapy techniques, the National Asthma Council of Australia (8) prepared a guide based on expert reviews on the effectiveness of complementary therapies. The council regards the following techniques as ineffective in the treatment of asthma; diet modification (e.g. use of omega 3 fatty acids &lactobacillus), chiropractic, and other physical therapies like massage, yoga, hypnotherapy, ionization, osteopathy and reflexology.
Those with considerable benefits on asthma treatment include relaxation therapy, speleotherapy, music therapy, and meditation. Breathing exercises, Buteyko breathing techniques, traditional Indian, Chinese, and Japanese herbal medicines, and homeopathy have also been proved to have some benefits in the management of asthma. The council however advises that due consideration should be made in relation to the side effects of using these techniques; patients should always consult their doctor first before using the complementary therapies (8).
Avoiding allergens
According to Barnes, Rodger, and Thomson (9), there is a very strong connection between allergens and the occurrence of asthma attacks. Allergens are known to trigger the body’s immune system causing the person to start coughing, sneezing, wheezing, or feeling itchy. These reactions occur when the person is exposed to common substances which do not lead to an allergic reaction in other people. Johansson and Haahtela (10), consider allergen avoidance as the best treatment measure as far as asthma attacks are considered. There are many ways of allergens like avoiding using fitted carpets, ensuring there is good air circulation in the houses, and modifying the designs of houses. People with known asthma attacks should avoid tobacco smoke and other allergens as well. In cases the environment is so polluted, such people are advised to relocate to new places in order to minimize the risk of severe attacks and avoid the need to take any medication.
Recommendation
Since the patient seems to suffer from acute attacks of Asthma, he needs to continue using the bronchodilator (Ventolin) that he is currently using. The patient should also consider using relaxation techniques as it seems clear that he could have been overactive in the recent past leading him to use the inhaler more than before. The relaxation would help him to ease any anxiety he could be experiencing lately. It is also important for the patient to also evaluate his current location to establish if the latest developments in his asthma condition could be linked to environmental conditions, if there is a significant relation to any environmental factor/s to the worsening of his condition, it would be advisable that he leaves to a place that presents him with little risk to prevent asthma from worsening than it already is.
Reference List
Australian Bureau of Statistics. Chronic disease. [Online] 2008. Web.
Gershwin, ME, Albertson, TE. Bronchial asthma: principles of diagnosis and treatment.4thEd. New Jersey: Humana Press; 2001 p.155.
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Asthma is a medical condition that has been a very important health issue in the world. It is also one of the highest causes of health problems in Australia. It is estimated that the prevalence of the condition in Australia is 10 – 25 percent among children below eight years and about 10-12 percent among the adult population. This is one of the highest rates in the world today. Though not a major cause of mortality, asthma is among the most prevalent health problems that doctors have to deal with and it is often the reason for hospitalization of children particularly boys. Asthma is described as an inflammatory disorder that chronically affects the airways in the lungs. The disorder usually causes problems of breathing since the lungs are the major organs for respiration. An asthma attack occurs during a broncho-constriction where these airways narrow suddenly and the muscles around the airways tighten. The mucus membrane around these air passages becomes inflamed and swell and the mucus glands secrets more mucus that tend to block air causing a feeling of breathlessness.
Asthma Treatment
Asthma attacks usually last briefly or can be felt for several days. For this reason, the medication for the condition is divided into two groups. One acts very fast and is often used for faster relief while the second category is a long-term control [1]. It is also important to note that asthma is incurable though the treatment available can improve the quality of life by alleviating the adverse symptoms of the asthma attack [1, 9].
Long-term medications are used on an everyday basis to keep control of unrelenting asthma [4]. They are basically used to prevent inflammation of the air passages in the lungs [2]. The rapid-acting treatments are taken to quicken the process of reversing acute asthmatic attacks by causing the relaxation of the smooth muscles of the bronchial system.
Use of Medication
Several methods can be used to manage the asthmatic problem. They range from monitoring the activity of the lungs to the use of medication. The medication can be categorized according to the mode of their activity to achieve relief of the symptoms [2]. These medications are divided into two categories that are corticosteroids which are the anti-inflammatory drugs and bronchodilators which are mainly muscles relaxants [3].
Anti-Inflammatory Corticosteroids: these drugs work by reducing the inflamed number of cells and also by preventing more secretion of fluids into the airways [2]. Through these means, the drugs are able to reduce sudden constriction of the airways. When a spasm does not occur, the risk of an asthma attack is reduced [9]. Corticosteroids are usually administered in two basic formulations; the aerosols which are the dosages through spray delivered by a Metered Dose Inhalers or they can be taken orally through pills, tables, or liquid formulations [1]. Inhaled formulations include drugs like Aerobid brand (flunisolide (active)), Beclovent (beclomethasone), and Azmacort (triamcinolone). The pill and tablet formulations are Deltasone (prednisone) also known by names like Meticorten and Paracord, Medrol (methylprednisolone), and Delta Cortef (prednisolone) also called Sterane. The liquids include Prelone and Pedipred mostly used for asthmatic children [3]. There is a new line of drugs that are called leukotrienes which include drugs like Accolate (Zafirlukast) and zyflo (zileuton). Leukotienes mediate the process of inflammation. When these drugs are taken, this is inhibited hence no inflammations occur [3].
Bronchodilators: as suggested in the name they cause the bronchial systems to dilate by relaxing the smooth muscles around them [3]. The flow of air is hence enhanced. Some of them include drugs like Alupent – inhaler (metaproterenol) and Brethaire (terbutaline), Severent – inhaler (salmeterol), and Aerolite – oral (Theophylline). These drugs help to manage asthma when a person is exposed to the irritants that cause the inflammation like at night during sleep [3, 9].
A second classification of the drugs is usually based on the duration of action. Long terms drugs are used for daily control of inflammation over a very long period [3, 4]. Examples here include inhaled steroids like Aerobid (flunisolide) and Pulmicort (budesonide); leukotriene modifiers like Singulair (montelukast) and Accolate (zafirlukast); Theophylline pill; beta-agonist like salmeterol; and combined inhalers like symbicort (Formoteral + budesonide) [5].
Short acting medications are used for quick relief of symptoms of act attacks and such drugs include beta agonist (albuterol); Atrovent (Ipratropium) and IV and Oral cortico-steroids [9, 10].
Treatments Available in Australia for Asthma
There are several types of medication for asthma in Australia that are documented together with either mode of delivery for convenience and efficiency [6]. There is a chart that indicated the colors of these medications. The up-to-date list is comprised of 43 different drugs that are on the market to treat asthma in Australia [7]. The product can be easily recognized as they are usually placed against the current packaging where they are grouped according to classes as well [6]. The classes include relievers, symptom managers, Non-steroid preventers, combined medications, and corticosteroid preventers [6].
Preventers are drugs like Flixotide (orange), tidal (yellow), Intal Forte (white), and Alvesco (rust). These preventers reduce the sensitivity of airways hence swelling and inflammation are lowered. They have to be taken daily and take a while before reaching optimal capacity [7].
Relievers like Ventolin (blue), alleviate the symptoms in a few minutes by relaxing the smooth muscles of the airways, and the flow of air is enhanced. Symptom controllers like Serevent (green) and Foradile (blue). These drugs help in relaxing the smooth muscles around the air passages for long hours up to 12 [10]. They are taken on a daily regimen. Combined medication includes Seretide which is a concoction (purple) of Serevent and Flixotide and Symbicort which is a mixture of Oxis and Pulmicort. These drugs have to be taken concurrently every time every day as prescribed [9].
Recommendation for Appropriate Drug
Patient X, a managed 30 year has previously been diagnosed with asthma by his general practitioner. The only medication available for him is the Ventolin Inhaler used Pro re nata (PRN). However, for the previous fortnight, he has been using the Ventolin puffer at three puffs four times every day regularly [10]. The patient is healthy and fit; he is not on any other medication.
Analyzing the cases above, the patient needs to take a stepwise approach to solve his health problem. The treatment should begin with a beta-2 agonist which should be taken prn [3,8]. Ventolin is appropriate for this as he does not indicate any symptoms that can cause alarm [5]. If the symptoms get to moderate or mild, then inhaled corticosteroids can be introduced. Serevent or Oxis can be used here. They reduce symptoms and prevent exacerbation of symptoms. To maintain the normal function of the body it’s advisable to consider the long-term beta-2 agonist (salmeterol) on a fixed dosage regimen [4,8]. They effectively exacerbate adverse symptoms. If symptoms worsen, the amount of Inhaled corticosteroid is increased and an MDI spacer is introduced [8]. Consider using anti-leukotrienes or Oral Theophylline, though the not first line of defense, Theophylline greatly reduces symptoms of asthma. They are effective than LABA. Finally, oral steroids are can be recommended by a specialist and the lowest possible dose used [9].
Reference List
Australian Institute of Health & Welfare. Patterns of Asthma Medication Use in Australia. [Online] 2007. Web.
Balter MS, Bell AD, Kaplan Ag, Kim H, & McIvor RA. Management of Asthma In Adults. Can. Med. Assoc. J., 2009, 181(12): 915 – 922.
Barnes PJ, The Role Of Inflammation And Anti-Inflammatory Medication In Asthma, Respiratory Medicine, 2000, 96(1): 9-15
Bateman ED, Hurd SS, Barnes PJ, Bousquet J, Drazen JM, Fitzgerald M, et al Global Strategy For Asthma Management And Prevention: GINA Executive Summary, Eur. Respir. J., 2008, 31(1): 143 – 178
Barnes PJ. New Drugs for Asthma, Nature Reviews Drug Discovery 3, 2004: 831-844
Chu EK, Drazen J M, Asthma: One Hundred Years of Treatment and Onward. Am. J. Respir. Crit. Care Med, 2005, 171:1202-1208
Currie GP, Lee DK & Srivastava P, Long-Acting Bronchodilator or Leukotriene Modifier as Add-on Therapy to Inhaled Corticosteroids in Persistent Asthma?, 2005, 128(4): 2954 – 2962.
Herborg, H. Improving Drug Therapy for Patients with Asthma — Part 1 Journal of the American Pharmacists Association, J Am Pharm, 2001, 41: 4.
Lasley MV. New Treatments for Asthma Paediatrics in Review, 2003, 24: 222-232.
Russell FD, Coppell AL, Davenport AP. In vitro enzymatic processing of radiolabelled big ET-1 in human kidney as a food ingredient. Biochem Pharmacol, 1998 Mar 1; 55(5): 697-701
Asthma is a chronic inflammatory disease that is characterized by swelling and narrowing of airways. The patient experiences shortness of breath and chest tightness (Fanta, 2009), among other symptoms. Once the airways have been inflamed, this initiates an asthmatic attack. On the other hand, the lining of air passage also swells (Brozek et al., 2010). In Japan, the prevalence of bronchial asthma is at 5% and is steadily increasing among the adult population (Brozek et al., 2010). In Japan, bronchial asthma causes nearly 3000 deaths annually and although it has been declining in recent years, it is still high in comparison with other Western countries (Koyanagi et al., 2009). Therefore, bronchial asthma among the Japanese population is a significant issue in as far as asthma management is concerned.
Factors that cause asthma among Japanese
In a study conducted by Nakazawa and Dobashi (2004) to determine the factors contributing to the high rates of asthma among the adult population in Japan, it emerged that fatigue, respiratory infections and stress are among the leading causes of fatal asthmatic attacks. Other reports have also suggested that the recent rapid reduction in Asthma deaths among the Japanese could be linked to increased use of inhaled corticosteroids. The rapid increase in asthma deaths has also been linked to poor asthma education among patients, lack of enough education on asthma, and the inability by medical practitioners to effectively examine the severity of the condition. In a review carried out by Alvarez et al (2005), it emerged that abrupt cessation or improper treatment of such agents as inhaled corticosteroids (ICS) is one of the leading risk factors for fatal or near-fatal asthma. Additional factors include rhinovirus or influenza infection and older age.
In a report by Nakazawa (2004) in which the author sought to determine the trend of asthma mortality among the Japanese population, emotional stress and fatigue emerged as the leading factors for the causation of asthma. A number of factors have been noted to be the major causes of asthma exacerbation, including near-fatal or fatal attacks. In this regard, the Japanese Society of Allergology has come up with 16 factors that are closely related to asthma exacerbation. In their study in which they sought to determine the link between asthma exacerbation and thunderstorms, Girgis et al (2000) noted that thunderstorms resulted in exposure to such antigens as certain allergens and pollen, thereby exacerbating asthma. In this regard, exposure to allergens and several weather changes have played a key role in worsening the asthmatic condition of patients in Japan.
Environment
In spring, the Asian dust storm (ADS) that sweeps across East Asia, including Japan and these winds have been noted to have severe effects on the health of the Asian populace. This observation prompted Wanatabe et al. (2011) to conduct a correlation study among the population in Western Japan to determine the link between ADS and worsening asthma attacks among the population. The respondents to the study were interviewed via a telephone survey. The research findings revealed worsening lower respiratory symptoms among 22 of the 98 patients in the month of April which coincided with an increase in pollen levels. This observation prompted the researchers to conclude that ADS worsened lower respiratory symptoms among asthma patients in Western Japan.
Social-cultural determinants of health
A growing body of research has linked health to cultural and social factors (Marmot & Wilkinson, 2006). Social variables such as socioeconomic status, sex roles, ethnicity, gender, race, poverty, acculturation, social networks and poverty potentially impact on health outcomes in the complete disease etiology right from its onset to progression and finally, survival. Additional factors include social cohesion and income distribution. All of them play a key role determining the prevalence and aetiology of asthma.
Controlling the spread of asthma
The spread of asthma can be prevented by identifying and controlling asthma triggers. Examples of asthma triggers to avoid include smoking and second hand smoke. Quitting smoking and living in a smoking free setting goes a long way towards reducing the spread of asthma. Dust and dust mites should also be avoided and reduced. This can be accomplished by dusting of the living and working areas regularly, and maintaining low indoor humidity (van Dellen et al., 2008). Animals with feathers of fur should also be avoided and preferably kept out of the house. Homes should be kept free of dampness and well aerated to avoid mold and mildew that may trigger asthma. Pollen should also be avoided.
Effects of populations’ beliefs and values on treatment options
Patients and doctors have differing beliefs as regards the treatment options for asthma. Also, families’ and patients’ exploratory models (Ems) tend to differ based on sociocultural factors and personality. As such, it is important for health care practitioners to ensure that they are fully acquainted with the different beliefs patient beliefs as regards asthma so that they can play a key role in enhancing patient-doctor communication. This would go a long way towards ensuring that asthmatic patient stick to the treatment regimen prescribed to them. Proper management of asthma calls for a thorough understanding of patients’ beliefs on the illness and its treatment. Asthma can only be managed well when we have the right understanding of the widely held beliefs by patients (Nishima, 2009). One such belief holds that asthma is not a chronic illness but an acute one. Furthermore, most patients lack the necessary knowledge on self-management and course of asthma (Brozek et al., 2010). There is need therefore for health care providers to become acquainted with such beliefs and to also share such beliefs in asthma educational programs.
Preventing asthma at the community level
If at all we are to prevent the escalation in the prevalence of asthma, it is important to identify and develop health promotion and wellness strategies that can be implemented at the community level. One of these strategies is creating awareness among the community members that asthma is a significant public health issue that needs to be prioritized (Marmot & Wilkinson, 2006). This can be accomplished by holding periodic asthma awareness campaign in which various stakeholders such as the health care practitioners and community leaders mobilize and educate members of the community on the need to identify risk factors for asthma and how to avoid or reduce their impact on the health of the populace. Also, a community resource center can be established whereby information on asthma can be disseminated. Another strategy should be to incorporate a surveillance and evaluation program aimed at not only defining the burden of the disease, but also the program planning and guide policy, in addition to evaluating the effects of strategic plan activities aimed at reducing the prevalence of the disease. This can be accomplished by organizing annual monitoring programs aimed at identifying disparities and trends of the disease burden in the community.
Reference List
Alvarez , G. G., Schulzer, M., Jung, D., & Fitzgerald, J. M. (2005). A systematic review of risk factors associated with near-fatal and fatal asthma. Can Respir J 12, 265-70.
Brozek, J. L., Bousquet, J., Baena-Cagnani, C. E., Bonini, S., Canonica, G. W., & Casale, T. B., et al. (2010). Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines: 2010 revision. J Allergy Clin Immunol., 26(3), 466-76.
Fanta, C. H. (2009). Asthma. N Engl J Med., 360, 1002-1014.
Girgis, S. T., Marks, G. B., Downs, S. H., Kolbe, A., Car, G. N., & Paton, R. (2000). Thunderstorm-associated asthma in an inland town in south-eastern Australia. Who is at risk? Eur Respir J., 16, 3-8.
Koyanagi, K., Koya, T., Sasagawa, M., Hasegawa, T., & Suzuki, E., et al. (2009). An Analysis of Factors that Exacerbate Asthma, Based on a Japanese Questionnaire. Allergology International., 58, 519-527.
Marmot, M. G., & Wilkinson, R. D. (2006). Social Determinants of Health. Oxford, England: Oxford University Press.
Nakazawa, T., & Dobashi, K. (2004). Current asthma deaths among adults in Japan. Allergology International, 53, 205-209.
Nishima, S. (2009). Present state and problems of asthma treatment in Japan. JMAJ, 52(1), 50-53.
van Dellen, Q et al. (2008). Asthma beliefs among mothers and children from different ethnic origins living in Amsterdam, the Netherlands. BMC Public Health, 8, 380.
Wanatabe, M et al. (2011). Correlation between Asian Dust Storms and worsening asthma in Western Japan. Allergology International, 1, 60, 267-275.
The modern lifestyles adopted by many people across the globe have widely affected their health and social lives. In this case, man’s mode of diet has significantly changed from native foods to industrially manufactured foods, which have adverse effects on human health. Further with the development of urbanization and civilization, cultural and social activities have widely changed; where in this case humans are less or not involved in physical activities. Based on this, many diseases have recently cropped up thus endangering human life. Some of these diseases include hypertension, Asthma, Glaucoma diabetes, and heart failure among others.
Main Body
Additionally, a point to be considered is that most of these diseases have diverse symptoms that are closely related, where in this case it is evident that some of these diseases like; hypertension, diabetes, glaucoma, and asthma may crop up within the human body in a progressive phase. In addition to the discussion, the health history and behaviors of Mr. Ugo Storski show clearly that he had hypertension, asthma, type 2 diabetes, glaucoma, and osteoarthritis. On the other hand, his mother had Alzheimer’s which is a hereditary disease that could have been passed on to Mr. Storski her son; where in this case glaucoma and osteoarthritis are widely hereditary thus contributing to Mr. Storski’s current situation.
The most challenging behaviors of this victim are acute forgetfulness, which in this case makes it difficult for him to remember the tasks recently assigned to him; and the inability to remember the things he has been told or said. Further, the disorientation of this victim at home and the workplace is another challenging behavior, which has led to poor interaction between the victim and other workmates. Additionally, the victim has a very queer behavior of misplacing things and a speech impediment, which makes him a social misfit or feels misplaced socially.
Based on this discussion then it is very clear how difficult it is to live with such a person; since there will exist a lack of effective communication and a low degree of understanding between the victim and the other colleagues at the workplace. The assignment of duties is also a difficult task since the victim is forgetful and disoriented, which in this case may lead to delays or failures within the working system. The impediment of speech is also a very serious barrier to effective communication, as it may lead to the passing of the wrong information; thus leading to failures in pursuing the set objectives. The victim’s misplacement of objects is also an embarrassing behavior, which in this case may lead to the loss of working materials or delays in doing work; which may lead to the instance of great losses within the business.
Another point worth noting is that the best way to cope with such a victim within the workplace is through the provision of good medical help. In this case, the business should provide the necessary financial assistance to enhance the healing of the victim; which will on the other hand increase his efficiency at work. In the process of the medication, the victim should be given a rest from work; during which in this case the inconveniences caused by his deteriorating health may not affect the execution of the duties within the business. The assignment of light tasks and roles can also be another method of accommodating the victim within the workplace. In addition, adequate guidance and counseling to the patient are also important, as in this case, it will help the victim know how to live with the disease and avoid activities that may worsen his health status.
Conclusion
Based on the discussion, it is evident that most of the diseases affecting humans are due to changing lifestyles thus the need for adequate guidance regarding the lifestyles taken-to; with regard to diet patterns and exercising. Further, it’s wise to take the right measures to prevent and cure these diseases in time; so as to avoid the varied adverse effects associated with them in the long run.
Advances in complementary and alternative medicine are being made amidst interests to avail alternative cure for illnesses and sicknesses. The “Approximations” offered by complementary and alternative medicine in treating asthma has increasingly been sought by more patients following several failures of clinical medicine, as posited by Blanca, Gongora-Melendez, Esquer-Flores, Escalante-Dominguez, & Macias. Although the usefulness of complementary and alternative medicine in asthma is yet to be ruled out by scientific evidence, final conclusions are yet to be made regarding their efficacies and safety in treating asthma. Acupuncture has been used in treatment of chronic diseases in Japan, and its application in the treatment of chronic pulmonary disorders has been allowed by the World Trade Organization according to Suzuki, Yoko, & Hiroshi. Better quality of life is one of the positive results of acupuncture treatments that have been reported. Safer and more effective alternatives for asthma are needed with increased affected population. For example, an estimated 15 million people in the United States have been affected by asthma.
Patients with Asthma have shown a variety of responses to acupuncture, indicating the potential of complementary medicine in treating asthma. In study by Sternfeld, Fink, Bentwich, and Eliraz, patients showed reduction of “bronchodilator and taper completely corticosteroid therapy”. Acupuncture has also been found to be useful in treating COPD (Chronic Obstructive Pulmonary Disease) and UIP (Usual Interstitial Pneumonia). Jobst has posited that acupoints could be dynamic points that can “initiate a physiological response when the conditions are right”, as posited by Jobst. Treating asthma patients with acupuncture has reported more success elsewhere-“decreased concentrations of SlgA and total IgA (in saliva and in nasal secretions) and levels of IgE in sera after treatment” according to Yang et al.
A lot of literature has been developed concerning the effectiveness of acupuncture in treating asthma, and it appears that many cases refute the usability of the method. Reviews of several publications have found flaws in research that support the effectiveness of acupuncture in treating asthma. The case for the effectiveness of acupuncture in the treatment of asthma is to be further supported by more research studies, since current and past research has been affected by a number of limitations or flaws that have limited or affected the evaluation of the usability of acupuncture in treating asthma. These limitations include the cultural barriers of the studies, lack of standardization in treatment, as well as small samples of patients (see Gyarik & Martin). It appears that inadequate prove exists for or against the utilization of acupuncture in asthma therapy. The operation of acupuncture on asthma, as well as for other sicknesses needs to be explained using the criteria for understanding and judging modern therapies, so that its application, effectiveness and validity can be understood more.
In conclusion, there are no clear indications whether acupuncture is effective in treating asthma. While some studies and cases have reported positive results based on the patient experience, other studies have refuted the claim that acupuncture is effective in treatment of asthma. The validity and reliability of studies supporting effectiveness of acupuncture treatment for asthma has been indicated as lacking, because the judgment has been based on the patients’ experiences and feelings.
References
Blanca R, Gongora-Melendez A, Esquer-Flores J, Escalante-Dominguez J, & Macias A. The role of acupuncture in asthma. Rev Alerg Mex. 2007; 56 (5): 154-7.
Gyarik S, & Martin B. Complementary and alternative medicine for Bronchial Asthma: Acupuncture. Curr Opin Pulm Med, 2004; 10 (1).
Jobst A. A critical analysis of acupuncture in pulmonary disease: efficacy and safety of the acupuncture needle. J Altern Complement Med. 1995; 1 (1):57-85.
Sternfeld M, Fink A, Bentwich Z, and Eliraz A. The role acupuncture in asthma: changes in airways dynamics and LTC4 induced LAI. Am J Chin Med. 1989;17 (3-4): 129-134.
Suzuki M, Yoko Y, Hiroshi, Y. Research into acupuncture for respiratory disease in Japan: a systematic review. Acupunct Med. 2009; 27 (2): 54-60.
Yang Y, Chen H, Zhao C, Wang R. Studies on regulatory effects of acupuncture on mucosal secretory IgA in patients with allergic asthma. Chen Tzu Yen Chiu. 1995; 20 (2):68-70.