Use of Inhaled Corticosteroids in the Management of Chronic Asthma in Elder Adults
Asthma is a disease that is on the rise in America despite the fact that medical therapies have improved over the past 15 years. According to the Center for Disease Control and Prevention (2010) there are 17.5 million individuals living with asthma in America, and 456,000 of those individuals are being admitted to the hospital each year for acute exacerbation (National Heart, Lung, and Blood Institute, 2007). Extensive research studies have demonstrated that regular use of inhaled corticosteroids can control asthma symptoms and prevent exacerbations (Solomon & Ho, 2015). However asthma control remains suboptimal in at least 5% of patients diagnosed with asthma (Gamble, Stevenson, McClean & Heaney, 2009).
This paper will compare the effectiveness of inhaled corticosteroids and Extensive research bronchodilators in individuals with asthma. PICO: In adult individuals with a diagnosis of asthma, does adding an inhaled corticosteroid to the medical regimen decrease the number of acute exacerbations as compared to use of an inhaled bronchodilator alone? Don't use plagiarised sources.Get your custom essay just from $11/page
Significance of the Problem
Despite treatment with inhaled bronchodilator medication, acute exacerbations of asthma, and death from asthma in individuals over age 65, are on the rise in the United States. Several research studies have shown that adding inhaled corticosteroids to the patient’s medication regime decreases the number of acute exacerbations by 60% (Smith, 2016). This in turn would decrease the number of work days lost, number of outpatient clinic visits, and number of hospitalizations, saving approximately 30 million dollars a year in overall cost (Appleton, 2013).
During a 10 week clinical rotation in an outpatient geriatrician’s clinic, the author of this paper noted that there were 2-3 patients per day who were only using an inhaled bronchodilator as treatment for their asthma. All of these patients had symptoms of wheezing and/or shortness of breath on average 3 days a week, indicating that the current medication was not sufficient in treating their disease.
Theoretical/Conceptual Framework
The Stetler Model was used because…. The Evans Hierarchy was used to evaluate each article…
Search Strategy
Research articles were collected by searching the Pub Med and Cinahl databases. Inclusion criteria used in the search of articles included elders, elder adults, asthma, pharmacologic treatment, exacerbations, dyspnea, risk factors of mortality, predictors of exacerbation, health related quality of life, and chronic illness. Exclusion criteria included were pediatrics, emphysema, and Spanish. After an exhaustive search there were 2 RCTs, 1 systematic review, and 2 cohort studies utilized for this paper.
Review of Literature
Conclusion
Asthma remains poorly controlled despite medical advances in treatment regimen among the adult population. There are several reasons for this, the main one being lack of inhaled corticosteroid medication use. The intention of this paper was to show, through research studies, that adding an inhaled corticosteroid to the medical regimen of an individual with asthma decreased the number of acute exacerbations. The studies evaluated indeed showed that use of the combination of inhaled bronchodilators and corticosteroids decreased symptoms, and thus acute exacerbations, by as much as 60% (Howard and Gavin, 2014). Although this would save millions in health care costs the main benefit is that individuals with asthma can live productive lives without shortness of breath and constant fear of admission into the hospital.
References