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ECPB 2013, 62(2): 81–89
Assisting a doctor

Features of providing the primary medicare to patients with severe chronic obstructive pulmonary disease and co-morbid arterial hypertension

LASYTSYA T.
Abstract

The objective of the study was to analyze the most significant co-morbid disorders of cardiovascular diseases and severe chronic obstructive pulmonary disease (COPD) in ambulatory patients. Methodological approaches to the elaboration and implementation of local clinical pathway on arterial hypertension in the State Institution of Science “Research and Practical Center of Preventive and Clinical Medicine” State Administrative Department has been exposed. Adequate pharmaceutical support and regular follow up in co-morbid patients have been offered. Recommendations for pharmaceutical support and regular follow up are based on the diagnostics and treatment guidance – GOLD (Global Initiative for Chronic Obstructive Diseases), renewed in 2011 and Recommendations of the Ukrainian association of cardiologists for prophylaxis and treatment of arterial hypertension (2008) which take into account the features of patients with the combined defeat of the cardiovascular and respiratory systems.

COPD belongs to the second half of life, results in a proof irreversible obstruction, takes place on the background smoking, and the starting mechanism of heavy sharpening is pneumonia or hearths of constantly chronic infection. Sharpening has heavy protracted character, which needs a self-weighted complex therapy. For the permanent use in primary medicare for patients with heavy chronic obstructive disease and arterial hypertension a wide spectrum of preparations is used. Because of it, special value is acquired by the timely and correct setting of preparations for permanent treatment.

2 appendixes are developed to local protocol “Preparations for treatment of COPD taking into account influence on the cardiovascular system” (Addition 1) and “Preparations for treatment of arterial hypertension taking into account influence on the respirator system” (Addition 2) Application of such additions in clinical practice of doctors of primary link will help to prevent side effects, especially in “difficult” patients with the combined defeat of the cardiovascular and respirator systems.

In the State Institution of Science “Research and Practical Center of Preventive and Clinical Medicine” State Administrative Department recommendations were developed in relation to the conduct of patients with heavy motion of COPD and arterial hypertension. Setting of medicinal treatment is regulated in accordance with developed in establishment of local clinical protocols of diagnostics and treatment. Tactics of setting separate groups of preparations is grounded, taking into account concomitant pathology and individual features of patients.

Keywords: chronic obstructive pulmonary disease, arterial hypertension, comorbid, clinical pathway

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