Chronic obstructive pulmonary disease (COPD) is a respiratory condition that is characterized by difficulties in the air flow (Vestbo, et al., 2013). The Global Initiative for Chronic Obstructive Lung Disease has provided a series of reports on COPD from 2001 highlighing its diagnosis, prevention, and management (2015). The condition is associated with both long term and short term treatment which does not necessarily cure but ease the suffering associated with it (GOLD, 2015). The high resource utilization that is attached to this condition is attributed to by both its chronicity and high prevalence. Establishing an appropriate diagnosis of COPD is significant in that the ideal management of the condition and aids in decreasing the symptoms associated.
Diagnosis
The clinical diagnosis of COPD should be considered to patients or any other person who displays the symptoms of the condition. Such persons to be considered may be having symptoms such as a chronic cough, sputum production, dyspnea, or evidence a history that illustrates exposure to the causal factors of the condition (GOLD, 2015). Utilization of spirometry is of the essence in the diagnosis of OCPD (GOLD, 2015). The condition is confirmed in the patient if the presence of post-bronchodilator as per the diagnosis is less than 0.7 (Raghavan, et al., 2012). Such measurements confirm the aspect of limited air flow which affirms the OCPD condition.
Management
After the diagnosis of OCPD, management is necessary to minimize the symptoms of the condition and prevent future negative impacts of the condition. The management should commence by pointing out the risk factors of the condition and the ways of reducing such factors (GOLD, 2015). All patients that are active smokers should be motivated to stop the habit which is one of the critical factors towards development and worsening of the condition. Regular assessment at a personal level should be incorporated in the management of OCPD (GOLD, 2015). Engagement in physical activity is recommendable in the management. Utilizing this approach in the management of the condition is of relevance in improving the patients’ tolerance to regular life activity and positively controls the symptoms associated with the condition such as fatigue and dyspnea (Vestbo, et al., 2013). Although no medications have been conclusively developed in the venture of long-term treatment of the decline in lungs function, embracing of pharmacologic therapy should be utilized in the management to reduce the symptoms (GOLD, 2015).
Vestbo et al. (2013) opine that exacerbations form one of the highest risks towards exposing the patient to the fatal repercussions of the condition. This can be managed by giving the patients long term treatment with corticosteroids through inhalation. Other medications should be incorporated in the management of OCPD such as the use of influenza vaccines. Use of this vaccine helps in the overall reduction of risks that are associated with the condition such as cases of low tract respiratory infections that may lead to hospitalization (GOLD, 2015). For patients possessing a clinically stable OCPD, antibiotics should be used for only treating the exacerbations and bacterial infections that are associated with the condition (Vestbo et al., 2013).
Prevention
Vestbo et al. (2012) assert that one of the most studied risk factors of COPD is cigarette smoking. The studies have revealed that consistent cigarette smoking causes the development of the airflow limitation. Therefore, avoiding of cigarette smoking or the presence of the cigarette smoke minimizes the chance of developing the condition. The lifestyle of a person which includes the occupational exposures may lead to the development of the condition (GOLD, 2015). Inhaling of inorganic or inorganic specks of dust, fumes, and chemical agents are known to evoke the development of OCPD (Vestbo et al., 2013). Therefore, avoiding such risk factors can be embraced as another preventive measure of the condition. Evidence continues to support the assertion that pollution from biomass results with COPD (GOLD, 2015). Thus, control of overall pollution can lead to the realization of another preventive measure.
Implementation of the Strategies in a Clinical Setting
Although no conclusive prevention strategy has been developed for COPD, utilizing of the findings from the completed studies may be of significant in this sector (Vestbo, et al., 2012). Since cigarette smoking has been mostly researched as one of the causal factors of COPD at the moment, stopping of the smoking habit should be advocated in the clinical setting (GOLD, 2015). Counseling of the patients of adverse repercussions of this drug and coming up with measures that can help cigarette addicts to quit this habit can act as a preventive measure (Vestbo, et al., 2012). Similarly, at a clinical level, the health care service providers should advise the people on the causes of the condition such as pollution hence advocating for a pollution free environment (GOLD, 2015).
Diagnosis of the Patient in the Case Study
The patient of interest in this particular case study is named as John, a 68-year-old male. Among the symptoms that he had been displaying match the COPD symptoms mentioned in the COPD guidelines. The patient had a worsening cough and produced green sputum. He later experienced breathless experiences where he could not walk or even eat. This evoked the need for incorporation of spirometry which gave a result of 0.68 FVC evidencing presence of COPD (Dodds, 2013). Upon more evaluation of the patient, it was found that he was a heavy cigarette smoker confirming it as a risk factor for the condition.
Treatment and Management of the Patient
The patient was prescribed to use bronchodilators as a management of the breathlessness (Dodds, 2013). In addition to this, some antibiotics and steroids were recommended. In comparison with the COPD guidelines, antibiotics are necessary for conditions accompanying OCPD and not for the cure of this condition. Frequent monitoring of the blood glucose and respiratory rate was recommended as an ultimate solution of evaluating his progress (Gold, 2015). Stopping of cigarette smoking and participation in numerous exercises was given as additional recommendations (Vestbo, et al., 2012.)
References
Global Initiative for Chronic Obstructive Lung Disease, Inc. (2015). Pocket guide to COPD Diagnosis, Management, and prevention. Retrieved from http://www.goldcopd.it/materiale/2015/GOLD_Pocket_2015.pdf
Dodds, L. J. (2013). Drugs in use: Clinical studies for pharmacists and prescribers (5th ed.). London: Pharmaceutical Press.
Raghavan, N., Lam, Y. M., Webb, K. A., Guenette, J. A., Amornputtisathaporn, N., Raghavan, R., & O’Donnell, D. E. (2012). Components of the COPD Assessment Test (CAT) associated with a diagnosis of COPD in a random population sample. COPD: Journal of Chronic Obstructive Pulmonary Disease, 9(2), 175-183. https://dx.doi.org/10.3109/15412555.2011.650802
Vestbo, J., Hurd, S., Agustí, A., Jones, P., Vogelmeier, C., & Anzueto, A. et al. (2013). Global strategy for the diagnosis, management, and prevention of Chronic Obstructive Pulmonary Disease. American Journal of Respiratory and Critical Care Medicine, 187(4), 347-365. https://dx.doi.org/10.1164/rccm.201204-0596PP
Vestbo, J., Hurd, S. S., & Rodriguez‐Roisin, R. (2012). The 2011 revision of the global strategy for the diagnosis, management, and prevention of COPD (GOLD)–why and what? The clinical respiratory journal, 6(4), 208-214. doi: 10.1111/crj.12002
