Penanganan PPOK melalui Pendekatan Ilmu Kesehatan Masyarakat di Puskesmas Muara Batu

Abstract

Chronic Obstructive Pulmonary Disease (COPD) is a progressive chronic respiratory disease closely associated with long-term exposure to irritants and contributes to reduced quality of life as well as an increased burden on healthcare services. This case reports a 49-year-old male farmer who presented to Muara Batu Primary Health Center with progressive chronic dyspnea that worsened with physical activity, accompanied by productive cough, fatigue, and limitation of daily activities. The patient had a long-standing smoking history with a severe Brinkman Index, as well as environmental exposures including cigarette smoke, dust, waste-burning smoke, overcrowded housing, and barriers to routine access to treatment. Physical examination revealed barrel chest, widened intercostal spaces, hyperresonance on percussion, and decreased bilateral vesicular breath sounds, supporting a working diagnosis of COPD based on history taking and physical examination. The patient was managed through a comprehensive approach, including smoking cessation education, reduction of irritant exposure, improvement of household ventilation, optimization of inhalation therapy, use of mucolytics when indicated, breathing exercises, energy conservation, monitoring of exacerbation warning signs, and regular follow-up. This case demonstrates that COPD management in primary care should integrate pharmacological therapy, risk factor modification, environmental interventions, simple pulmonary rehabilitation, and family support to reduce the risk of exacerbation and maintain the patient’s quality of life.