Patient-Centered Comprehensive Approach in Combined Pathology Management: Asthma / Copd Cross

Abstract

Introduction. Bronchial asthma and chronic obstructive pulmonary disease are serious social, epidemiological and medical health problems worldwide. The purpose of the study is to determine the main risk factors of asthma / COPD cross exacerbations in order to develop patient-centred management. Materials and methods. The study included 35 patients with asthma / COPD cross, and 35 healthy individuals. To quantify their well-being, the patients were asked to complete questionnaires: Asthma Control Questionnaire, Modified Medical Research Council Breathing Scale; to determine the level of reactive and personal anxiety, we used the questionnaire of Ch. D. Spielberger – Yu.M. Hanin. The analysis of integral indicators of the function of external respiration, including the test with bronchodilators was carried out. Medical lifestyle assessment of each patient with asthma / COPD cross was conducted by using the questionnaire of A. Nosov "Formation of components of a healthy lifestyle." Bioimpedance analysis of body composition was carried out as well. On the basis of the disturbances revealed in the behaviour of patients with asthma / COPD cross, and on the observance of lifestyle modes, we elaborated improved patient-centred approach to select the most appropriate algorithm of actions and personal behaviour to each patient. Conclusions. The integrated therapeutic measures developed for the patients with asthma / COPD and burden medical history should include in addition to the standard therapy (inhaled glucocorticosteroids, long-acting β2-agonists and / or long-acting muscarinic receptor antagonists) customized rehabilitation methods (therapeutic gymnastics according to Buteyko, hardening of the body, dietary modifications, mandatory smoking cessation) that promotes the stabilization and regression of symptoms, the increase in lung functioning, physical endurance, and improves patient’s quality of life.