Medication Adherence

Part 1: Medication Adherence

Two common classes of medications used to manage COPD are bronchodilators and
corticosteroids. Why are these medications used to manage COPD?
What are some common side effects of these classes of medications? Which of these side
effects would be reported and why? Which side effects would not be reported and why?
Describe any special instructions that would be included with each class of these
medications. For example, food-drug interactions and medications that should be avoided.

Which health care discipline, in addition to the RN, is best suited to help with medication
adherence? How will this team member collaborate with the RN, the patient and the family
to help promote medication adherence and a safe transition to home?
Part 2: Dietary Modifications
Part 2 must include the following:
What is the role of diet in managing COPD? What changes need to be made to the present
diet? What role does culture play with diet?
What obstacles might be encountered when informing the patient about the changes in
diet?
Which health care discipline, in addition to the RN, is best suited to help with dietary
modifications? How will this team member collaborate with the RN, the patient and the
family to help promote healthy eating and a safe transition to home?
Part 3: Physical Activity
Part 3 must include the following:
What is the role of physical activity in managing COPD?
How would the RN promote adherence to a daily activity routine?
Which health care discipline(s), in addition to the RN, are best suited to help with physical
activity? How will this (these) team member(s) collaborate with the RN, the family and the
patient to help promote physical activity and a safe transition home?
Part 4: Conclusion
Part 4 must include the following:
A detailed conclusion that includes an evaluation of the effectiveness of the
interdisciplinary team in making a safe transition for the patient with COPD.
Compose your work using a word processor (or other software as appropriate) and save it
frequently to your compute

MEDICARE PAYMENT RULES

Medication Adherence
The chronic obstructive pulmonary disease also known as COPD is a progressive disease
and a collection of many other lung illnesses (Holt et al, 2014). These lung complications include
chronic bronchitis, chronic obstructive airways illness and also emphysema. The diseases result

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to difficulties in breathing among the affected people. Exposure to lung irritants such as dust, air
pollution and chemical fumes in long term contributes to COPD. There are medications used to
manage the COPD condition. These medications help to control or prevent symptoms and reduce
deterioration of the conditions (Kamal et al, 2015). The commonly used and prescribed
medications are bronchodilators and corticosteroids. The bronchodilators are used to manage the
COPD by relaxing the muscles around the airways (Holt et al, 2014). The medication is useful as
it solves the breathing complications by widening the airways in the lungs. The medication is
commonly used as it helps control breathlessness. It also increases the effectiveness of
corticosteroids. The corticosteroids medication is used as it helps prevent flare-ups and reduce
the rate of inflammation in people affected by the COPD. The medication is used to control
exercabations and the symptoms experienced in COPD (Holt et al, 2014). The reduction in
symptoms and effective control of breathlessness condition makes the medications be commonly
used in the management of COPD.
The medications are accompanied by side effects. The common side effects of using
bronchodilators include trembling, nausea, and vomiting, nervousness and suddenly noticeable
heartbeats. Some of the corticosteroids side effects include high blood pressure, loss of muscle
mass, mood changes and headaches. Some of the side effects that are commonly reported are
heart disease complications, fragile skin, and recurrent infections (Kamal et al, 2015). These side
effects might be reported because they are long term in nature thus their occurrence signifies
high risks. The severe long-term side effect prompts those affected to report to the relevant
people. There are also side effects that would not be reported by those affected. They include
nausea, nervousness, trembling, mood changes and headaches that are constant in nature. Such
side effects are short-lived with minimal severe cases among those that take this type of

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medication (Holt et al, 2014). These side effects are short-term thus most people believe they are
normal experiences that end quickly after some short duration. The side effects can only be
reported if they develop more serious complications. There are special medications included
while using these medications. The bronchodilator medication should not be used unless the
diagnosis is properly done by the physicians.
There are instructions for allergies such as preservatives, food and dyes while using the
medication. The pregnant patients should take high caution and consult the physicians before use
of the bronchodilators (Kamal et al, 2015). They may result in birth defects in cases where
pregnant women take the medication. Rinsing and proper gargling of the mouth is an important
instruction during use of corticosteroid medication to prevent throat irritation and hoarseness.
Testing and priming of the inhalers before use is a special and necessary instruction while taking
the corticosteroid medication (Holt et al, 2014).
Adherence to medication is crucial during the management of COPD disease and other
illnesses. The physical therapist and psychology professions would be better placed as the best
health care disciplines. The therapist will play a major role and collaborate with others including
the registered nurse to help patients in medical adherence. The health interdisciplinary teams will
combine efforts to achieve the treatment goals for the patients (Kruis, 2014). Collaboration with
the RN in assisting the patients is essential to their adherence medical improvement.
Communication with the patients and imparting the appropriate knowledge is one strategy used
during these collaborations (Kruis, 2014). When the patients and families understand more about
their conditions and the treatments, this is positively related to adherence. The RN will assist in
the diagnoses, evaluation and assessment of the conditions. The therapist or psychology
profession will acquire the necessary information used to monitor medications as administered

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and come up with strategies to improve compliance (Kamal et al, 2015). As a team member
involving the families and the patients in the assessment of the condition through discussions and
forums is key in improving compliance. The strategies used during the collaborations should be
patient-centered and also ensure relevant people such as the families are involved. The
collaboration with the RN will help in coming up with better-integrated intervention for quick
recovery of the patients (Holt et al, 2014). The collaboration will help in the formulation and
implementation of a standard set of procedures and behavior policies that influence the
medication compliance positively. Such strategies will ensure the patients leave the health care
settings quickly and a safer transition home (Kruis, 2014). The medical adherence of the patients
will be efficiently improved.
Dietary Modification
Management of COPD is crucial to reducing the prevalence of the diseases and also
prevention of symptoms occurrence. The diet plays a major role when it comes to the
management of the COPD. Diet and proper nutrition will help reduce the levels of carbon
dioxide intake and improve breathing that is a major issue associated with COPD (Yilmaz et al,
2015). The healthy diet in COPD patients will facilitate weaning from mechanical ventilation. It
is through the provision of calories required to meet metabolic needs and also reduce
hypercapnia. Diet and nutritional depletion will lead to the improved respiratory function. Some
changes are essential while managing COPD while having diet in mind. These changes provide
the better dietary tips to be adopted to ensure the actions boost the condition of patients suffering
from COPD (Holt et al, 2014). The primary focus of dietary strategies on one group or specific
individuals should be changed. Interventions should focus on a wider range of COPD patients.
Self-management and diet counseling are crucial to ensure successful interventions.

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Opportunities for nutrition and dietary interventions in the management of COPD should
be explored with the objective of early detection, early prevention, and treatment (Yilmaz et al,
2015). Voluntary adjustment of the dietary behavior is a successful intervention. More fruits and
proteins should be among the changes that need to be considered in the present diet. Avoidance
of foods with many chemicals is vital change to the present diet. Small amounts of nutrient-rich
meals should be ensured while eating to avoid breathlessness.
The culture influences the type of diet adopted. It is the role of the culture to develop the
most appropriate diet (Yilmaz et al, 2015). The culture will influence the type of healthy lifestyle
behavior adopted in a certain environment by different individuals. Culturally based perceptions
and practices of a particular group will determine the appropriate diet to be used by members of
such an environment. The role of culture in the dietary strategies will be based on factors such as
mode of food preparation, preference and also nutritional status (Vestbo et al, 2013). The culture
should ensure the diet is most appropriate for adoption to the promote health of its members.
Communication of the diet changes to people might be faced with some obstacles. The notions
and different perception by those been informed about the diet changes will lead to ineffective
communication (Vestbo et al, 2013). The people might rubbish the information due to the
stereotypic strong belief of the best diet in their culture. The poor cooperation by those been
informed and also the negative attitude to dietary changes makes the process of communication
inefficient. Advocating for better health policies or dietary changes is a difficult when there is
insufficient support from the health interdisciplinary teams (Kruis, 2014). Such obstacles make
the process of informing people about diet changes cumbersome.
The health care discipline is essential during the COPD management through dietary
modifications. The registered dietitian will be best suited to offer help when it comes to the

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modification of the diet among people. The dietitian who is a member of the larger registered
health care discipline team will collaborate with the registered nurses, patients, and the family to
ensure healthy eating among individuals (Yilmaz et al, 2015). The dietitian will identify the risks
of some nutrients in a certain diet and suggest a change or supplementation of the patient’s diet.
The registered nurse will help in the identification of the necessary nutrients and
supplementation needed in the changed diet (Kruis, 2014). The nurses will help in the
reinforcement of the dietary plan and provision of feedback about the patient’s condition. The
close relationship between the family and dietitian will ensure the patients are taught about
therapeutic diets and their importance. The family of the patients will help in monitoring the
effects and improvement noted after diet changes. The dietitian will work with the RN and the
patient in the development of a plan that will help the patient replete their body’s nutritional
needs (Yilmaz et al, 2015). The registered nurses will help the dietitian when coexisting health
problems arises.
Physical Activity
Physical activity is of great importance during the management of COPD. The physical
activities will mainly refer to practices such as exercises. It is essential to carry out regular
exercises in one’s lifestyle. A physical exercise is one way of staying healthy especially in
COPD patients. Physical activity will help improve circulation and ensure the body utilizes the
oxygen in the best way possible (Miravitless et al, 2012). The activities will also strengthen the
cardiovascular system and heart. The physical activities will help build one’s energy to be able to
carry out many activities without becoming short of breath or tired which is common among the
COPD patients. The physical activity will also increase endurance among COPD patients that
will help reduce recurrent infections among them (Miravitless et al, 2012). In this case, the

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COPD symptoms will be improved and effectively controlled. The exercises will improve
muscle strength and tone thus improving joint flexibility and balance. The improvement will help
better the health of COPD patients which is a vital measure in the management of the illness. The
inflammation is one problem associated with COPD condition. The physical activity will help in
strengthening of respiratory muscles. Physical activity plays a major role in the improvement and
control of symptoms for effective management of COPD (Miravitless et al, 2012).

The RN has a major role in promoting the adherence to physical activities. The registered
nurses can develop some coping strategies that are useful especially during stressful situations
(Yilmaz et al, 2015). The RN can use the positive imagery and self-talk to help avoid negative
thoughts about the routine daily activities. The RN can carry out counseling or educate those
involved in the activities. The educations will focus on lessening the worry to injuries while
carrying out the activities as it might be a barrier to adherence (Vestbo et al, 2013). The routine
patient visits in primary health are vital in promoting the daily routine physical activities among
patients and also their adherence. The RN can enhance self-efficacy among the patients with the
use of theories such as the social cognitive theory that is key in the maintenance of certain
desirable behaviors. The benefits of the exercises will be advocated the patients who will
consequently promote the adherence to the routine daily activity (Vestbo et al, 2013). Daily
communication with the patients about their issues and progress is vital in increasing their
compliance that promotes their adherence to the routine. Proper follow-up, provision of
information and close relationship between RN nurses and the patients will promote the
adherence to the daily physical activities (Yilmaz et al, 2015).

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It is necessary to have the health care disciplinary to help in the promotion of adherence
to the physical activities. The physical therapist, the exercise physiologist and also the personal
trainer would be best suited to help in physical activities. The disciplines will help the patients in
the understanding of the health issue and the plan to be adopted for improvement. The physician
will assist the patients in following the right procedures during physical activities to avoid
injuries but instead ensure their well-being (Miravitless et al, 2012). The nurses will be helpful in
the reinforcement of the teachings and practices they offer to the patients. The effective
collaboration with the patients, families and the RNs will be increased through effective
communication. The physical therapist will provide teachings to the families and patients about
mobility and on how to carry out activities safely. The occupational therapy will ensure the
patients adapt to the activities that will also promote their adherence. The occupational and
physical therapists will depend on RNs to educate the patients about their conditions and the
importance of exercises (Miravitless et al, 2012). The nurse will collaborate with the physicians
in the reinforcement of instructions provided. The patient participation in the activities will be
provided by the nurses as feedback where they will also encourage the patients which promote
adherence. The effective collaboration will be made possible by proper communication between
all involved personnel which will in turn ensure the patients are taught collaboratively which
increases their adherence to the activities (Yilmaz et al, 2015). The physical therapist, family,
patients, nurses and other health disciplines should work together to maintain a positive attitude
in patients towards physical activity. Such measures will promote adherence for a safer transition
home.
Conclusion

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The interdisciplinary teams have a major role to play in the management of COPD. The
efforts are aimed at making the transition of COPD patients safer (Kruis, 2014). The
collaborations are central to the effective patient care in the health settings. The effective
communication between the interdisciplinary teams helps in improving the satisfaction levels
among the families and patients. It will also ensure that the length of stay in hospitals is reduced
and symptoms in patients controlled in the best possible way (Kruis, 2014). The collaborations
which are all about the combined efforts will also ensure that the hospital costs are reduced for
the COPD patients. The collaborations are effective in the achievement of positive and cost
effective outcomes during the management of COPD. The proper collaboration will help in
creation and maintenance of the trusting relationship between the patients their families and the
healthcare professionals (Donaire et al, 2013). The interdisciplinary teams will work together to
ensure the continuity of care is efficient. Patient care conferences, consultations, and the proper
documentation will imply the collaboration is effective and focused towards the main goal of
improvement of health. Recognition of areas of expertise by each and also the mutual respect
among the interdisciplinary team will be important in ensuring the collaboration is effective
(Donaire et al, 2013). Working towards a common goal is an effective way by the
interdisciplinary teams to ensure the safer transition of COPD patients.

References

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Donaire-Gonzalez, D., Gimeno-Santos, E., Balcells, E., Rodríguez, D. A., Farrero, E., de Batlle,
J., … & Garcia-Aymerich, J. (2013). Physical activity in COPD patients: patterns and
bouts. European Respiratory Journal, 42(4), 993-1002.
Holt, E. W., Rung, A. L., Leon, K. A., Firestein, C., & Krousel-Wood, M. (2014). Medication
Adherence in Older Adults: A Qualitative Study. Educational Gerontology, 40(3), 198-
211.

Kamal, A. K., Shaikh, Q. N., Pasha, O., Azam, I., Islam, M., Memon, A. A., & … Khoja, S.
(2015). Improving medication adherence in stroke patients through Short Text Messages
(SMS4Stroke)-study protocol for a randomized, controlled trial. BMC Neurology, 15(1),
1-9. doi:10.1186/s12883-015-0413-2
Kruis, A. L. (2014). The effectiveness of integrated disease management in COPD patients
(Doctoral dissertation, Department of Public Health and Primary Care, Faculty of
Medicine? Leiden University Medical Center (LUMC), Leiden University).
Miravitlles, M., Soler-Cataluña, J. J., Calle, M., Molina, J., Almagro, P., Quintano, J. A., … &
Ancochea, J. (2012). Spanish COPD Guidelines (GesEPOC): pharmacological treatment
of stable COPD. Archivos de Bronconeumología (English Edition), 48(7), 247-257.
Vestbo, J., Hurd, S. S., Agusti, A. G., Jones, P. W., Vogelmeier, C., Anzueto, A., … &
Rodriguez-Roisin, R. (2013). Global strategy for the diagnosis, management, and
prevention of chronic obstructive pulmonary disease: GOLD executive summary.
American journal of respiratory and critical care medicine, 187(4), 347-365.
Yılmaz, D., Çapan, N., Canbakan, S., & Besler, H. T. (2015). Dietary intake of patients with
moderate to severe COPD in relation to fat-free mass index: a cross-sectional study.
Nutrition Journal, 14(1), 1-10.

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