Abstract

Aim:
Prevalence rates of asthma and obesity are rising internationally. Obesity adversely affects asthma control and outcomes. Weight management is not a feature of SIGN, NICE, European, American, Canadian, BTS and GINA guidelines as part of routine care. Despite the known association none of the aforementioned guidelines acknowledge the positive effect weight reduction may have on asthma control . This analysis was undertaken as a pilot for a quality improvement weight reduction initiative for asthma patients with high BMI.
Method:
Electronic patient records of asthmatic patients (n=272) were analysed for worsening ACT scores with rising BMI, and concomitant asthma treatment escalation most likely due to the raised BMI.
Results:
Of the pilot study of 272 patients, 68.75% had asthma with a BMI >25, and 32.36 % had BMI between 25 and 30 and the mean average BMI was 27.41, of these 99 patients had BMI over 30 mean average 35.27.
We found as expected a correlation between high BMI >25 and increased risk of exacerbation, lower ACT scores in the preceding 12 months in these patients and 72.28 % were often on triple therapies (LABA, LAMA, ICS) combination inhalers. None of the patients with high BMI were offered weight management as part of routine asthma care
Conclusion:
We searched national and international guidelines of asthma management and found an absence of obesity management as a part of routine asthma care. We believe holistic management of patients will lead to improved long term outcomes mental health and QoL scores . We are currently undertaking a quality improvement initiative offering patient education and weight management strategies and have incorporated this into routine care. We believe this study highlights the need to improve clinician awareness and offer holistic asthma management and guidelines should in cooperate weight management into routine care.