Loss of appetite in patients with chronic obstructive pulmonary disease - a mixed methods study.

Abstract

Background: Loss of appetite in patients with COPD can lead to malnutrition, which is associated with an increased risk of morbidity and mortality.

Aims: To identify factors associated with loss of appetite among COPD patients and explore their' experiences regarding appetite and eating.

Methods: A questionnaire on demographics, medical history and containing the Council on Nutrition Appetite Questionnaire (CNAQ) was posted in a COPD-specific online forum. CNAQ is validated to examine loss of appetite in older adults. The questionnaire contains 8 questions with five ordinal answer options. Ten patients who answered the questionnaire were randomly recruited for semi-structured phone interviews.

Results: Eighty-seven patients responded to the questionnaire. 61% had loss of appetite. Patients with loss of appetite had a lower FEV1% predicted (31% vs. 42%, p = 0.03), higher CAT-score, (23 vs. 18, p = 0.002), and a higher proportion lived alone, (68% vs. 32%, p = 0.02), and got all daily meals delivered (19% vs. 0%, p = 0.009). Among the interviewed patients, the following factors influenced their appetite: Lack of daily routine, insufficient knowledge on nutrition, lack of social contact, bodily limitations, inadequate help and support, limited physical activity and lack of acceptance of life situation.

Conclusion: Patients with loss of appetite are characterized by a low BMI, impaired lung function, more symptoms and live alone. Improvement in social contact and support, nutritional support, and acceptance of their current life situation will help address these challenges.