Challenges Faced in the Management of Asthma in Elderly Patients

CHALLENGES FACED IN THE MANAGEMENT OF ASTHMA IN
ELDERLY PATIENTS
BY
Minil Thomas
GDCN (Chronic diseases)
BSc Nursing
Submitted in partial fulfilment of the requirements for the degree of
Masters of Clinical Nursing
College of Nursing & Midwifery
Charles Darwin University
(May, 2019)

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Keywords
1. Asthma
2. Challenges
3. Elderly patients
4. Older adults
5. Young adults
6. Management
Author: T Minil May 2019

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Abstract
Background: Asthma is an incurable health condition of the respiratory system which causes
respiratory suffering in patients. The disease roots irritation and narrowing inside of the lung,
limiting air supply. This respiratory condition has a major influence on aged population. It
has been observed that elderly patients suffering from asthma remain at high risk of
witnessing ill health due to asthma and the death rate is also found to be high. And the main
reason behind the issue is the ageing pathophysiology. In older patients, the under-diagnoses
of asthma are quite common hence the under-treatment occurs. And it has been observed that
management of aged asthma patient is challenging. In this systemic literature review, the
research problem considered will focus on the poor management of elderly asthma patient
and the research question “what interventions can provide better progress in asthma
symptoms for elderly asthma patients?”
Method: Systematic review of 11 articlesfrom PubMed, Medline, CINAHL,
EMBASE and Google scholar database and search engine. The articles were published on or
after 2009, and were evaluated using the JBI tool for analysis. Search terms were “aged”,
“elderly”, “elder”, “older”, “senior”, “asthma”, “respiratory disorder”, “respiratory illness”,
“respiratory disease”, “asthma attack”, “adult”, “grownup”, “asthma disorder”, “asthma
illness”, “management”, “supervision”, “administration”, “challenge”, “difficulty”, “cure”,
“trail”, “exertion” and “treatment”.
Results: Of the 11 articles obtained, two were of high quality, and rest 9 were of moderate
quality. Three notable themes emerged namely, (i) The impact of comorbidity on the
treatment challenges in elderly people with Asthma disease, (ii) Challenges faced in
management of medication and compliance among older adults who have been diagnosed
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with asthma, and (iii) Challenges encountered at the time of asthma under-diagnosis amid
elderly patients.
Conclusion: Poor adherence to medications, overlapping symptoms, co-morbidities, lack of
health literacy, and depression increase the exacerbation of asthma symptoms among older
adults and worsen their quality of life.
Author: T Minil May 2019

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Table of Contents
List of figures.............................................................................................................................5
List of tables...............................................................................................................................6
List of appendices......................................................................................................................7
Statement of original authorship................................................................................................8
Acknowledgements....................................................................................................................9
Introduction..............................................................................................................................10
Aim:......................................................................................................................................12
Objective:.............................................................................................................................12
Research question:...............................................................................................................12
Pico Framework...................................................................................................................12
Methodology:...........................................................................................................................15
Standards for including the studies:.....................................................................................15
Identification of studies:.......................................................................................................16
Result:......................................................................................................................................18
The impact of co-morbidity on the treatment challenges in elderly people with Asthma
disease:.................................................................................................................................18
Challenges faced in management of medication and compliance among older adults who
have been diagnosed with asthma........................................................................................22
Challenges encountered at the time of asthma under-diagnosis amid elderly patients........25
Discussion................................................................................................................................28
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Implications for clinical practice and recommendations.........................................................31
Conclusion................................................................................................................................32
References................................................................................................................................34
Appendix 1...............................................................................................................................38
Appendix 2...............................................................................................................................49
Appendix 3...............................................................................................................................50
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List of figures
Appendix 3- PRISMA flowchart
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List of tables
Appendix 1- Critical appraisal
Appendix 2- Quality assessment
Author: T Minil May 2019