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More routine malnutrition screening in COPD patients needed, says guidance

The role of nutrition needs to be given greater priority in managing patients with COPD, according to updated guidance endorsed by the RCGP.

Despite recent NICE COPD guidelines that include information on identification and management of malnutrition, it is not always considered as part of treatment, those behind the guidance warn.

Recommendations in the updated ‘Managing Malnutrition in COPD’ guide include regular BMI checks and routine nutrition screening of all COPD patients, using a validated risk tool.

The updated guide also includes advice on when to prescribe oral nutrition supplements, including in all COPD patients with a BMI less than 20kg/m2.

Dr Anita Nathan, a sessional GP in central London, who is a member of the RCGP’s group for GPs with an interest in nutrition and helped to develop the updated advice, said there had been a major focus on nutrition related to obesity – but the consequences of malnutrition often seem to be ignored.

She said: ‘I think GPs are becoming aware of the role that good nutrition plays in achieving better disease outcomes but it is not routinely seen as a priority to incorporate nutrition into treatment plans.

‘It costs over three times more to treat malnourished patients, regardless of other factors, due to increased GP visits, hospital admissions and prescription costs.

‘Nutrition is often not the focus in COPD, but patients are particularly at risk of malnutrition and the disease risk is higher.’

She acknowledged that GPs had limited time during consultations, but stressed that the guidance comprised simple steps, including making sure BMI was documented.

She said: ‘It is just about asking patients and carers questions about eating and drinking during consultations. What I hope is that we can really start to target those high-risk groups.’