Multidimensional individualized nutritional therapy for individuals with severe chronic obstructive pulmonary...

Area of Science:

• Pulmonary Medicine
• Nutritional Science
• Clinical Trials

Background:

• Severe chronic obstructive pulmonary disease (COPD) patients are at high risk of undernutrition, negatively impacting health-related quality of life (HRQoL).
• Undernutrition exacerbates COPD, increases comorbidities, and predicts functional decline, leading to higher healthcare use and mortality.
• Exacerbations and infections in COPD patients frequently cause unintentional weight loss.

Purpose of the Study:

• To evaluate the effectiveness of an individualized nutritional intervention for individuals with severe COPD.
• To assess the intervention's impact on health-related quality of life (HRQoL) as the primary outcome.

Main Methods:

• An open-label, randomized controlled trial with two parallel groups was conducted.
• The intervention group received standard care plus a 3-month individualized nutritional plan, adherence support, and a weight diary.
• Outcomes measured included HRQoL, functional capacity, disease-specific quality of life, anxiety, depression, nutritional status, body composition, and prognosis.

Main Results:

• Primary outcome: difference in HRQoL (EQ-5D-5L) between groups at 3 months.
• Secondary outcomes: changes in functional capacity, disease-specific quality of life, mood, nutritional parameters, body composition, and prognosis.
• Data collection involved home visits at baseline and 1 and 3 months post-intervention.

Conclusions:

• Nutritional care is currently underemphasized in outpatient management of severe COPD.
• If proven effective, this patient-centered nutritional approach could be recommended for end-of-life care in severe COPD, potentially improving HRQoL and reducing mortality and hospital contacts.