Značajke skrbi za bolesnike od kronične opstruktivne bolesti pluća u obiteljskoj medicini

master's thesis

• Title (english): Care for patients with chronic obstructive pulmonary disease in family medicine
• Author: Marija Babić
• Mentor: Goranka Petriček (mentor)
• Committee member: Ksenija Kranjčević (predsjednik povjerenstva)
• Committee member: Venija Cerovečki Nekić (član povjerenstva)
• Committee member: Goranka Petriček (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Family Medicine); Zagreb
• Defense date and country: 2023-07-13, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Public Health and Health Care; Family Medicine

Abstract

Kronična opstruktivna bolest pluća (KOPB) stanje je u kojem zbog promjene strukture dišnih putova dolazi do progresivnog pojavljivanja simptoma poput zaduhe, kroničnog kašlja, pritiska u prsima, a moguća je i pojava egzacerbacija. Glavni rizični čimbenik za nastanak KOPB-a je pušenje. Simptomi nisu uvijek specifični samo za KOPB, pa se u diferencijalnoj dijagnozi može pomisliti na srčano zatajenje, bronhiektazije, astmu, pneumoniju, tuberkulozu. Pri dijagnostici, važno je uzeti dobru anamnezu i... More napraviti fizikalni pregled bolesnika. Za postavljanje dijagnoze KOPB-a i procjenu stupnja opstrukcije dišnih putova koristi se spirometrija. Ukoliko je post-bronhodilatatorni omjer FEV1/FVC manji od 70%, bolesnik ima KOPB. Nakon potvrde dijagnoze, radi se procjena stanja bolesnika. Procjenom simptoma (mMRC, CAT skala) i povijesti egzacerbacija, bolesnici se grupiraju u tri skupine: A, B i E (GOLD 2023). Ovisno o skupini kojoj pripadaju, bolesnicima se propisuje inicijalna terapija KOPB. U liječenju se koriste bronhodilatatori (kratkodjelujući i dugodjelujući), kortikosteroidi, antibiotici i drugi lijekovi. U liječenju je važan individualizirani pristup, suradnja i pravilno uzimanje terapije. Prestanak pušenja i plućna rehabilitacija važne su nefarmakološke mjere liječenja. Važno je liječiti i prisutne komorbiditete. Obiteljski liječnik ima važnu ulogu u skrbi za bolesnike koji boluju od KOPB-a u dijagnozi, liječenju i praćenju bolesnika. U cilju ostvarenja skrbi visoke kvalitete preporuka je implementacija modela podijeljene skrbi engl. shared care koji predmnijeva zajedničko djelovanje obiteljskog liječnika i specijaliste konzultanta u pružanju planirane skrbi za bolesnika, prije svega pulmologa, potom kirurga. Pri tom je nužna komunikacija i razmjena informacija između ovih liječnika. Less

Abstract (english)

Chronic obstructive pulmonary disease (COPD) is a condition in which progressive symptoms such as shortness of breath, chronic cough, chest pressure, and exacerbations are possible due to changes in the structure of the airways. The main risk factor for COPD is smoking. The symptoms are not always specific to COPD, so the differential diagnosis may include heart failure, bronchiectasis, asthma, pneumonia, and tuberculosis. When diagnosing, it is important to take a good medical history and... More perform a physical examination of the patient. To confirm the diagnosis of COPD, spirometry is used, a test that can determine the degree of airway obstruction. If the post-bronchodilator FEV1/FVC ratio is less than 70%, the patient has COPD. After confirming the diagnosis, the patient's condition is assessed. Symptoms (mMRC, CAT scale) and history of exacerbations are looked at, and patients are grouped into three groups, A, B, and E (GOLD 2023). Depending on which group they belong to, patients receive associated therapy. Bronchodilators (short-acting and long-acting), corticosteroids, antibiotics, and other drugs are used in the treatment. It is important to cooperate and take the therapy correctly. Smoking cessation and pulmonary rehabilitation are important non-pharmacological treatment measures. It is also important to treat comorbidities if the patient has them. The family medicine doctor plays an important role in the care of patients suffering from COPD in all stages of diagnosis, treatment, and in patient follow-up. . In order to achieve high-quality care, it is recommended to implement a shared care model, which presupposes the joint action of a family doctor and a consultant specialist in providing planned care for the patient, first of all the pulmonologist, then the surgeon. At the same time, communication and exchange of information between these doctors is necessary. Less

• Keywords: Kronična opstruktivna bolest pluća; liječenje; obiteljska medicina; spirometrija
• Keywords (english): Chronic obstructive pulmonary disease; treatment; family medicine; spirometry
• Language: croatian
• URN:NBN: urn:nbn:hr:105:552298
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-10-20 10:08:13