Population Based Care (graded)
The article by Ulugbek et al. (2012) is about the effectiveness of holistic care interventions to patients with severe Chronic Obstructive Pulmonary Disease. The researchers found out that the interventions involved nurse-led coordination and case management roles. The Thailand-based CCT requiring coordinated community support showed a considerate effect regarding a three month follow up leading to the improvement of HRQoL, exercise tolerance, dyspnea and s satisfaction with care about the support of low level among the control group. The researchers also examined the American Phoenix Care intervention impact that had sub-domains of outcome transient and measures. They also found that the Australian intervention did not show any significant benefit. Thus, from this study, it shows that there is no strong evidence that can help to inform the designing of holistic interventions necessary to support individuals with severe COPD (Agustí, Soler, Molina, et al., 2012).
As a leader in health care policy, this study by Ulugbek N (2012) proposes that there is a need for additional healthcare policy changes. As a healthy care policy advocate, I have to play a key role in ensuring the improvement of health among individuals with severe COPD. My key consideration for evaluating and developing intervention is to consider the outcome measures. I may, for example, look at coinciding admissions as one of my outcome as my policy interests in healthcare planning. However to assess the overall impact of the intervention the most appropriate method can be the HRQoL.
Other symptoms like breathlessness may be a central problem among individuals with severe COPD. However, the isolated housebound patient may face other social concerns that are of paramount importance in my policy planning. From the article the management of COPD is a symptomatic challenge when trying to evaluate a wide holistic intervention since its effect can be expected to be the right outcome and a more diverse one. Thus, there is a need for me to work with other nurses and policymakers in reaching a consensus on the core outcomes of trails on the issue of providing a holistic intervention to individuals with severe COPD. There is an urgent need to evaluate rigorously and develop the best intervention meant to enhance and deliver a holistic care and quality of life improvement to individuals with severe COPD So as to facilitate a synthesis of evidence in the future.
Apart from drug treatment, my proposed policy will also look into other now- pharmacological therapies which have proven to be useful in relieving symptoms among COPD patients. Such measures can be useful in assisting the management of patients with multiple co-morbidities and COPD. These measures may also require the need to adopt a new model of care so as to avoid attention fragmentation among multiple specialties. These measures include the need to prevent exacerbations, malnutrition, disability and depression treatment and comorbidities. There is also the need for patients to increase their physical activities, smoking cessation among other measures that are necessary for the improvement of HRQoL. Thus, the policy will champion the use of a multidisciplinary approach as well as the need to individualize these interventions since they are vital for managing patients with severe COPD (Agborsangaya, 2013).
Agborsangaya C, Lau D, Lahtinen M, Johnson J. Health-related quality of life and healthcare utilization in multimorbidity: results of a cross-sectional survey. Qual Life Res. 2013;22(4):791–799.
Agustí A, Soler J, Molina J, et al. Is the CAT questionnaire sensitive to changes in health status in patients with severe COPD exacerbations? COPD. 2012;9(5):492–498
Ulugbek N., Buckingham, S, Kendall, M., White P., and Pinnock H. (2012). The effectiveness of Holistic Interventions for People with Severe Chronic Obstructive Pulmonary Disease: Systematic Review of Controlled Clinical Trials. 2012; 7(10): e46433.