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.