Occupational Therapy And The Importance Of Adherence To COPD Therapy

The Burdens of COPD on Patients

Question:

Discuss about the Compliance Of Medications For Harboring Positive Outcomes In COPD Patients.

Over the years, it has been observed that the treatment for COPD (Chronic obstructive pulmonary disease) has been advanced, non-adherence to the medical regimes that poses a significant form of barriers that have relevance to the most favorable management. The underuse, overuse and the inappropriate use if continues might lead to the most prevalent form of non-compliance to the therapy (Alanin, 2015). It has been seen that an average of forty to sixty percentage of the patients who are suffering from COPD complies to the prescribed form of the regime and only one out of ten patients performs all the main steps for medications correctly.

Chronic obstructive pulmonary disease or COPD has the distinct characteristics of reduction in the daily activities and participation. For the COPD patients along with the medication therapy, pulmonary rehabilitation is necessary. There are some studies which state the effects of occupational therapy on the COPD patients. The occupational therapy in the patients of COPD shows the decrease in dyspnoea, increase of confidence in the job and an improvement in the activity of the lifestyle (Malapel-Empis et al., 2013). The COPD patients need the assistances of the Occupational therapists for the betterment of their day to day activities. The occupational therapists are been defined as the task for rehabilitation for the COPD patients by giving them the maximum functions for independence for sustaining the specific activities for the daily life.

The COPD patients needs the assistances of the Occupational therapists for the betterment of their day to day activities The occupational therapists are been defined as the task for rehabilitation for the COPD patients by giving them the maximum functions for independence for sustaining the specific activities for the daily life.

The therapies of COPD are majorly multi factorial and that can involve both the patients and the provider for the primary care. The effect of the instructions of the patients on the inhaler adherence and the rescue to the utilization of the medications for the patients with COPD do not feel parallel for the results that are good and that are reported by the patients who are suffering from asthma (Kirby et al., 2016). However, the use of the combined form of the inhaler may be facilitated to adhere to the medications that can improve the efficacy and the pharmaco economic factors for the influence of the selection of the patient for both the device and the regime. The health belief, behaviors and the experiences of the patients plays an important role in the therapy for adherence to the patients. The manuscripts also review that the patients with COPD are able to identify the predictors of the poor form of adherence (Fung et al., 2012).

The Effects of Occupational Therapy on COPD Patients

However, with the adherence to the medications, another factor that are needed for the COPD patients are the need for the Occupational therapists. The occupational therapy and the use of the self care and the activities of work and play promotes and maintains the health and prevents the form of disability and increases the independent form of functioning and can somehow enhance the rate of the development (Alanin, 2015). The organizations essentially includes all form of activities or the tasks that are been performed on every day basis. For example, being dressed, playing a form of sport, cooking the meals, taking the classes and working at the jobs are been considered as the form of occupation. The participants in the occupations serves various form of purpose that essentially includes, taking good care of themselves and then communicating with others for earning the living and developing the skills for contributing something for the society.

It is very much evident that the COPD patient suffers from many problems that remain unmet in their lives. The main problems that are certainly faced by them are their impairment from doing their daily activities. Now for them the need for the occupational therapists becomes immense. These patients who are suffering from COPD that essentially includes the problems related to the psychological, physiological or the symptomatical problems. The patients can have certain physical form of ailments that be reduced by the proper physiotherapy or the patient is going through a very low self-esteem that can be reduced by some expert advices from the occupational therapists. Therefore, the occupational therapists are needed for fulfilling the basic needs of the patients that are not been done by the doctors or the nurses (Alanin, 2015).

According to the World health Organization, it has been estimated that currently 210 millions of people are suffering from COPD and out of which three million people have died as per the records in 2005. The WHO has also predicted that soon COPD can become the 4^th form of cause for death worldwide in the year 2030. The burdens of COPD are assessed by the disability and the adjusted form of the life years that have been ranked 10^th in worldwide forum. The total number of death from the COPD can be thought to witness an increase by the amount of 30 percent in the coming one decade unless there has been any urgent form of the preventive measures that prevails in the in the place (Alif et al., 2016).

Factors Contributing to Non-Adherence in COPD Patients

The occupational therapy can help to improve the outcomes in the patients with chronic diseases for example COPD. Various pulmonary rehabilitation programs is being proposed for the improvement of the capacity and the life of the patients suffering from COPD. These programs help to improve the survival as they can modify the prognostic indicators. The pulmonary rehabilitation helps to relief from fatigue. It also improves the sense of control which the individuals can impose over their conditions. The mentioned improvements are clinically significant and large. These form a set of important elements of the management process of COPD and also help in improvement of quality of life (Anderson & Hennen, 2010).

Although it is a known fact that COPD cannot be cured properly and the optimal form of the management that provides the control of the symptoms slows the progression of the disease and may essentially bring improvement in the quality of life. The management of COPD may become suboptimal and when the physicians tends to fail for prescribing the appropriate form of therapies due to the evidence based guidelines and the under diagnosis, the patients aromatically adhere to the treatment of the regimes (Apps et al., 2016). Not many literary works exist on the knowledge of the physician and the patterns for the individuals with COPD that may lead to the suboptimal management and can have an adverse impact the outcomes of the patient.

Adherence can be defined as “the extent to which a person’s behavior (in terms of taking medications, following diets, or executing lifestyle changes) coincides with medical or health advice”.

There are various factors for the predisposition of the patients with COPD for their poor form of adherence. The recognition of this form of non-adherence in the patients who are suffering from COPD must always be the initial stage for the complicated form of process that leads to the improvement of the adherence. The prescription of the inhaled form of medication requires the knowledge from the different form of groups and there are options for the combination of potential form of clinical efficacy (Bendixen et al., 2014). It essentially requires being very much familiar with the several form of the aerosol delivery devices. There has been newer form of medications and several devices that improves the clinical form of outcomes and the ease for the use of typically mean and higher form of pocket expenses for the patients. The perception of the patients for their illness and their understandings for the treatments and their relationships with the primary form of care providers are the critical form of adherence to the therapy. The main purpose of the study is to know the importance of Occupational therapists to resolve the unmet healthcare services of the COPD patients. However, the literature reviews the various other researchers that had the same approach like the current study (Berekoff, 2017).

The Different Types of Non-Adherence

The main of the proposal is how the occupational therapists will provide knowledge to the COPD patients about the disease and their treatments.

Objective: To observe the effect of Occupational therapists on the ADL (activities of daily life) of the patients who are suffering from COPD from the past 5 years.

Three basic types of the non-adherence to the therapy exist: underuse, overuse and the improper form of use. The underuse is defined to be the reduction in the apparent in the daily use versus the standard of the dosage for the medications that has been indicated for the treatment or the prevention of the disease or the conditions. The improper use or the inappropriate use by confirming whether the drugs are been ineffective not indicated or there is an unnecessary duplication for the therapy (Enright, 2016).

Although there has been the three factors that contributes to the definition of the literature , where there are limited form of limitations that has the evidences that links the specific form of factors to each form of the non adherence in the patients with COPD that are underuse (Fung et al., 2012). By contrasting it, the improper form of use in the most frequent types of the non-adherence of the patients who are older than sixty-five years of age with the polypharmacy.

The factors with the tendency for the associations with the unnecessary drugs that are being used includes the white race, annual incomes that goes in to the prescribed form of medications and the lack in the health belief of the patients. In case of the older adults there are higher form of independence and the self reliance that have been associated in the lower form of adherence for the medications for considering the inappropriate form in the lack of effectiveness and the lack of the indications. The inhaled form of the medications are that are inappropriate is due to the lack of the effectiveness of the indications (Gardner et al., 2017). 

The patients who are suffering from the improper form of the COPD are generally due to the underuse of the proper medications. However, due to the forgetting of the occasional form of dose, the patients with the underuse have the higher form of risks for the morbidity that are related to adherences. The recent form of evaluations for the use of the ICS emerges from the primary care of the patients that have been revealed up to the thirty percent of the patients who did not have the clear form of indications for this form of medications. Although there are improper form of use for the that co exists in the same form that can coexists in the same patients, improper use may not correlate with underuse (Kirby et al., 2016).

The Importance of Adherence to COPD Therapy

However, evidences for the overuse of the short acting form of beta agonists in the patients who are suffering from asthma exist, but it is little known facts that the real incidences of the over usage in the patients who are suffering from COPD. During the respiratory distresses, it has been seen that roughly half of the patients have reported using more than the prescribed amount of the medications (Laver et al., 2017). 

The patients who are suffering from chronic obstructive pulmonary diseases often experiences the problems in performing the daily living activities. There are various researches that administers the self reported quality of the ADL task performances of the patients who are suffering from COPD (Li et al., 2017).

The majority of the patients who are suffering from the chronic obstructive pulmonary diseases tend to experirnce the decreased form of ability for performing the activities of the daily life tasks that are been caused for the diminished form of the quality of life. The COPD is achronic form of the disease that are been characterized by the shortening of the breadth, coughing that are been accompanied by some sputum, the reduced level of the functioning of the lungs, the deconditioning, anxiety and the depression. However, the pulmonary rehabilitation proggrammes for the groups of the patients who are suffering from COPD may certainly reduce the hospital readmissions, mortality and the exacerbation (Lundquist, 2015).

According to Gimeno-Santos et al., (2014), low level of physical inactivity is associated with poor prognosis in patients with COPD. As COPD patients are comparatively less physically active than healthy patients, it is necessary to understand the determinants and outcomes of physical activity in such patients to improve their health. Physical inactivity can occur due to many reasons but it can be treated among the patients with COPD. Pulmonary rehabilitation has drastically affected in the improvement of the physical activity in the COPD patients (Malapel-Empis et al., 2013).

Unmet health care needs can be defined as the difference between the healthcare services that is needed and services that are received. The basic determinant of health is the access to the health care and its distribution among the population which is a vital problem of the healthcare services (Martinsen et al., 2017). The unmet needs are considered as tools used for monitoring the access and the extent of use in health care.

As COPD is a progressive disease is often characterized by frequent occurring of respiratory failure. At this point the ethical dilemmas occur for deciding whether to initiate the mechanical ventilation for the patients of COPD. For the benefits of the ventilation in the patient with COPD, a physician must consider the results of the respiratory failure of the patient (Martinsen et al., 2017).

The Role of Occupational Therapy in Improving the ADLs of COPD Patients

There are some therapies such as pulmonary rehabilitation which emphasizes the behavioral change through the self management. It may lead to increase in the capacity of greater participation for the physical activities. Both of these capacities of exercise and the changes in behavior are important for achieving the long lasting increase in the physical activities in COPD patients (Michaeloudes et al., 2016).

The patients who are suffering from the improper form of the COPD are generally due to the underuse of the proper medications. However, due to the forgetting of the occasional form of dose, the patients with the underuse have the higher form of risks for the morbidity that are related to adherences. The recent form of evaluations for the use of the ICS emerges from the primary care of the patients that have been revealed up to the thirty percent of the patients who did not have the clear form of indications for this form of medications. Although there are improper form of use for the co exists in the same form that can coexists in the same patients, there might be an absence of a relationship between improper use and underuse (Petersen & Larsen, 2011).

However, there are evidences for the overuse of the short acting form of beta agonists in the patients who are suffering from asthma, but it is little known facts that the real incidences of the over usage in the patients who are suffering from COPD. During the respiratory distresses, it has been seen that approximately half of the patients have reported using more than the prescribed amount of the medications (Pierce et al., 2016).

The patients who are suffering from chronic obstructive pulmonary diseases often experience the problems in performing the daily living activities. There are various researches that administer the self reported quality of the ADL task performances of the patients who are suffering from COPD (Sewell & Singh, 2001).

The majority of the patients who are suffering from the chronic obstructive pulmonary diseases tend to experience the decreased form of ability for performing the activities of the daily life tasks that are been caused for the diminished form of the quality of life (Pinto-Plata et al., 2017). The COPD is a chronic form of the disease that are been characterized by the shortening of the breadth, coughing that are been accompanied by some sputum, the reduced level of the functioning of the lungs, the reconditioning, anxiety and the depression. However, the pulmonary rehabilitation programs for the groups of the patients who are suffering from COPD may certainly reduce the hospital readmissions, mortality and the exacerbation (Tsiligianni et al., 2017). de Groot PhD & van der Maas MSc, (2014) further showed that use of validated occupational tool might help to manage newly admitted patients with chronic pain in rehabilitation clinic. Such tools helps to interpret care and structure patient;s thought related to treatment and therapy.

Design of the study

The study is a Qualitative dissertation with a Narrative case study. The study is based on how theOccupational therapist helps to maintain the ADL (Activities of Daily Lives) of the COPD patients. The COPD patients were are selected from the Lung Foundation of Australia.. The researcher will design a fully structured form of interview with five participants. After identifying the patients who are suffering from COPD as the target population, five patients between the age group of 20 to 50 years will be selected and interviewed.  This will be achieved by seeking the consent of the participants, informing them about the significance of the research and eventually scheduling an interview to directly engage them by asking comprehensive short and long questions (Valenza et al., 2015)

Procedure

Firstly, the participants were given an introduction about the study from the researcher. The participants should fill the consent form that ensures that the participants are been interviewed due to their own will and they were not forced to give their interviews. Once the participants have given the consent, then the participants were being interviewed individually. The researcher recorded the responses of the participants. Each participant was provided with a questionnaire and was provided some space where they can freely express their views about COPD and their extent (Vizir & Berezin, 2015). They were also allowed to tell about their views for the benefits of treatment of the COPD. Once the participants have responded to the questions, the data collection was considered complete. Lastly, once the procedure is completed, the respondents were thanked for their responses. The contact information of the researcher and supervisor were provided if the participant were interested in the results of the study (Vizir & Berezin, 2015).

Limitations

Doctors, nurses, anyone who belongs to the field of medicine are excluded. The other important factor that should be taken into account before choosing the participants is the mood and mental health of the person. The person who seems to have a bad mood on the day of the interview is strictly avoided. For this study, both the gender both male and female participants were taken. Therefore, some biases can emerge which cannot be controlled.

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