Topic: Disease management
Discuss an acute case scenario that you observed in the clinical setting recently for the adult population ranging 35–65-year old.
Discuss how this case can develop into chronic disease management?
What was the evidence that supported the intended outcomes for this patient scenario?
Scenario 59 yo was being seen in the office as follow up s/p MVA and was having neck spasms. While in the office BP was elevated 170/110s. Had previously been prescribed meds by cardiology but has been non compliant for years. Has had no routine health maintenance or screening. No labs.
Scenario: A 59-year-old patient presented to the office for a follow-up after a motor vehicle accident (MVA) and complained of neck spasms. During the visit, their blood pressure was found to be elevated at 170/110 mmHg. The patient had a history of non-compliance with prescribed medications from cardiology for several years. Furthermore, there was a lack of routine health maintenance or screening, including lab work.
Development into Chronic Disease Management: This acute scenario of elevated blood pressure in a patient with a history of non-compliance and lack of routine healthcare can easily transition into chronic disease management. Hypertension, if left untreated or poorly managed, can lead to serious complications such as stroke, heart attack, heart failure, or kidney disease. The patient’s history of non-compliance with prescribed medications suggests a pattern of behavior that could exacerbate the development of chronic hypertension and its associated complications.
To manage this condition chronically, the patient would require consistent monitoring of their blood pressure, lifestyle modifications such as dietary changes and regular exercise, and adherence to prescribed medications. Additionally, routine health maintenance and screening would be essential to detect and manage any other underlying health conditions that may contribute to hypertension or its complications.
Evidence Supporting Intended Outcomes: In this scenario, the evidence supporting the intended outcomes would be based on clinical guidelines for managing hypertension and its complications. These guidelines recommend regular blood pressure monitoring, lifestyle modifications, and adherence to prescribed medications to achieve blood pressure control and reduce the risk of cardiovascular events.
Specifically, evidence-based guidelines such as those from the American College of Cardiology/American Heart Association (ACC/AHA) provide recommendations for the management of hypertension in adults. These guidelines emphasize the importance of lifestyle modifications, including dietary approaches to stop hypertension (DASH) diet, weight management, physical activity, and limiting alcohol intake. They also recommend pharmacological interventions based on individual patient characteristics and comorbidities.
In this case, the intended outcomes would include achieving and maintaining blood pressure within target levels to reduce the risk of cardiovascular events and improve overall health outcomes. Monitoring the patient’s adherence to medications, lifestyle modifications, and routine follow-up visits would be crucial in assessing the effectiveness of the management plan and adjusting it as needed to optimize outcomes.