Article Text


Clinical studies in obstructive sleep apnoea
P203 Management of obesity in respiratory clinics—are we doing enough?
  1. S Mandal,
  2. D J Powrie
  1. Southend University Hospital, Southend, UK


Introduction and Objectives Obesity is a growing problem and as Respiratory Physicians we are encountering more patients in clinics with co-morbidities associated with obesity. We wished to determine what services were available to patients with respiratory disease and obesity.

Methods We carried out a postal survey of respiratory departments in the UK.

Results 211 surveys were sent out and 100 were returned. 57 hospitals ran specialist sleep clinics, of those that did not have specialist clinics 41 saw obese patients in their general respiratory clinics. We asked about baseline measurements taken in clinic (BMI, waist circumference and collar size); 1 unit took no measurements; 23 took 1 measurement (most commonly BMI) and 60 took 2 measurements and 16 took all 3 measurements. 95 respondents gave their patients advice regarding the management of obesity. 1 hospital had a dietician available in clinic, 89 referred to a dietician; however, 10 had no access to a dietician at all. Physicians were asked about screening for co-morbidities. 81 units screened for hypertension, of these 47 (58%) referred back to the GP for management, 12 (15%) treated the hypertension themselves and 3 referred to specialists. 43 screened for diabetes, of these 18 (42%) referred to the GP for management, 2 treated the diabetes themselves and 10 (23%) referred to specialists. 16 screened for hypercholesterolaemia, 8 referred to the GP for management and 3 (19%) treated the hypercholesterolaemia themselves. Physicians were asked what other forms of advice/services were available in clinic, Abstract P203 Table 1. Clinicians were asked to rate on a scale of 1–10 about how happy they were with their current service, the average score was 4.55. We then asked how they felt their service could be improved, most commonly clinicians felt a dietician should be present in clinic (n=22) and that the service/clinic should be in a multidisciplinary format (n=16). Despite obesity and its co-morbidities being common, management in clinics is variable, as is access to services. An integrated pathway for the management of obesity may improve outcomes.

Abstract P203 Table 1

Modes of advice available in clinic

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