TY - JOUR T1 - Effective nutrition support for patients with chronic obstructive pulmonary disease: managing malnutrition in primary care JF - British Journal of General Practice JO - Br J Gen Pract SP - 427 LP - 428 DO - 10.3399/bjgp21X717053 VL - 71 IS - 710 AU - Peter F Collins AU - Anita Nathan AU - Shelley Roberts AU - Tom Wilkinson Y1 - 2021/09/01 UR - http://bjgp.org/content/71/710/427.abstract N2 - The prevalence of malnutrition is high among patients living with chronic obstructive pulmonary disease (COPD), affecting around 1 in 3 inpatients and 1 in 5 outpatients.1 Its consequences are profound, including poorer quality of life,1 increased emergency healthcare use, prolonged episodes of hospitalisation, early readmission, and increased health and social care costs.1The aetiology of malnutrition in COPD is complex, multifactorial (Figure 1), and is likely to be bidirectional, with malnutrition being both a cause and a consequence of severe respiratory disease. Research has also shown that malnutrition is significantly and independently associated with social deprivation regardless of COPD disease severity.2Figure 1. Complex aetiology of malnutrition in COPD. Source: adapted from Collins et al 2019.3 COPD = chronic obstructive pulmonary disease.While patients with COPD can present with varying predominance of the respiratory phenotypes, that is, chronic bronchitis and emphysema, all patients may experience functional symptoms such as reduced exercise tolerance, and nutrition impact symptoms including anorexia, shortness of breath, and early satiety. A poor nutritional intake is therefore likely commonplace in patients with COPD, particularly during exacerbations of the disease.3The evolution in our understanding of the systemic nature of COPD (that is, related to systematic inflammation and underlying pathophysiology) has resulted in a number of nutritional phenotypes … ER -