This latest research, published in the Clinical Nutrition journal, follows our story last week highlighting how researchers in Vietnam have argued that routine nutrition screening for COPD patients could avoid the development of malnutrition and its associated risks, costs and complications.
This latest study, from Queensland University of Technology, found that patients with chronic lung disease living in deprived areas in developed nations were more likely to be malnourished than those from wealthier areas.
It assessed 424 patients from a large city hospital and smaller rural hospital in the UK, were screened for malnutrition risk and their level of deprivation was assessed according to the UK Government's index of multiple deprivation.
Released to coincide with World COPD Day, the study found 22% of COPD patients were at risk of malnutrition, with those from more deprived areas significantly more likely to be at risk.
Dr Peter Collins, from QUT's School of Exercise and Nutrition Sciences, led the research with colleagues from the University of Southampton in the UK.
"Deprivation was greater among the COPD outpatients at the larger city hospital and 28 per cent of those patients were malnourished, compared to 17 per cent at the smaller hospital in a more affluent area," Dr Collins said.
"This study suggests for the first time that deprivation is one of the strongest predictors of malnutrition risk in COPD outpatients."
COPD is incurable and affects more than 1.45m Australians. The direct cost of COPD to the Australian healthcare system is estimated to be $900m and previous research by the QUT group found malnutrition in Australian COPD patients was associated with longer hospital stays and increased hospital costs.
Dr Collins said poor nutrition was a key driver for poor outcomes for patients with COPD.
"We already know people in deprived areas are more likely to get COPD. But now we know those people with COPD living in more deprived areas are also more likely to suffer malnutrition," he said.
"Social inequality in health has been an area of interest for governments around the world for decades. It is of course unfair for people to be more susceptible to illness because of their postcode and this research indicates where they live also predicts their risk of malnutrition".
"Clinicians must consider social deprivation when devising nutritional management plans for COPD patients."
Dr Collins also led the Vietnam study, where the team performed a cross-sectional pilot study in addition to a larger retrospective study, which together showed that malnutrition is very common among COPD patients in Vietnam and that new ways of identifying and easily screening patients are needed.
“Within the larger retrospective cohort, malnutrition was found to be a common clinical problem, with half of all patients assessed found to be at nutritional risk,” Collins and colleagues reported – adding that a similar prevalence (45%) was found within the smaller prospective cohort when full nutritional assessment was completed.