A responsible patient: from theory to practice on a model of a patient with bronchial asthma

Abstract

OBJECTIVE: Introduction: The medicine of today is focused on personalized aid to a patient, which involves partnership and mutual responsibility between the patient and the doctor. In our reality, the patient believes that the responsibility for the treatment and outcome depends on the doctor in most cases. The aim: Induce the patient to develop responsibility for the course of asthma against the background of EBW or obesity and introducing this program into the practice of family physicians. PATIENTS AND METHODS: Materials and methods: By design, the study included 75 patients with asthma with varying degrees of severity, persistent course in the remission stage against the background of EBW or obesity. According to the randomization method, the patients were divided into 3 groups: the main group - 30 patients (the use of medication), the comparison group - 30 patients (training in the "Asthma School"), the 3rd group was controls of 15 patients (basic therapy). RESULTS: Results: According to the anthropometric study, 75 patients enrolled in the study were found to have EBW or obesity and the mean BMI was 31.67 ± 0.53 kg / m2. It was also found that 20 (66.67%) patients in the main group and 21 (70.00%) patients in the comparison group did not regularly use basic therapy and cancelled or changed the drugs without permission. After the training, 45 patients (76.66%) of the total patients of the main group and the comparison group began to perform respiratory movements with the inhalation device correctly. patients in the main group reduced body weight on an average by 4.5 kg, and BMI from 32.00 kg / m2 changed to 29.7 kg / m2 (p <0.05), although they did not reach 25.0 kg / m2 of the target level because the follow-up period was not long. CONCLUSION: Conclusion: Only patients in the main group had significant positive changes in asthma control, the patients in the comparison group also had positive dynamics, but it did not show statistically significant differences. The doctor should be interested in the fact that at the first and subsequent visits regarding the disease, in our case it is bronchial asthma, the patient will feel responsible for the disease. Therefore, when communicating with the patient, the physician should focus on this, provide the most complete answers to the patient's questions, provide educational literature and, if necessary, diaries of self-control.