Holistic Management of a 74 Year Old Woman with Severe Persistent Asthma and Chronic Bronchitis Using a Family Medicine Approach

Abstract

Lower respiratory tract disease is still a serious problem for the elderly population. Among chronic lower respiratory tract diseases, asthma, and chronic bronchitis are the third leading cause of death in people aged 65 years and over. Both require appropriate and comprehensive management because they are chronic. This case report is to implement family doctor services in a holistic and comprehensive manner by identifying risk factors, clinical problems, and patient management based on Evidence Based Medicine with a patient-centered and family approach. Primary data were obtained through history taking, physical examination, and home visits. Secondary data were obtained from the patient's medical records at the Puskesmas Way Kandis. Assessment based on a holistic diagnosis from the beginning, process, and end of the study qualitatively and quantitatively. Patient Mrs. D, 74 years old, has complaint of shortness of breath and cough with sputum since 1 year ago, but it has gotten worse in the last 2 weeks. Shortness of breath accompanied by wheezing, intermittent, worsening at night, especially in cold weather, and when exposed to dust. The patient was diagnosed as severe persistent asthma and chronic bronchitis. After the intervention, there was a decrease in complaints and an increase in the knowledge of patient and family. The diagnosis of this patient was in accordance with the theory from several guidelines and journals, it was seen that there was a change in knowledge of the patient and family after an intervention based on Evidence-Based Medicine with patient-centered and a family approach.