Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jun 24:12:1531966.
doi: 10.3389/fcvm.2025.1531966. eCollection 2025.

Streamlining referrals by establishing a UAE-specific referral algorithm for CVD patients with overlapping COPD: a collaborative effort by cardiologists and pulmonologists

Abdulla Shehab  1 , Ashraf Alzaabi  2 , Abdulmajeed Al Zubaidi  3 , Bassam Mahboub  4 , Hadi Skouri  5 , Hamad Alhameli  6 , Hassan El-Tamimi  7 , Mohammed Nizam Iqbal  4
Affiliations

Streamlining referrals by establishing a UAE-specific referral algorithm for CVD patients with overlapping COPD: a collaborative effort by cardiologists and pulmonologists

Abdulla Shehab et al. Front Cardiovasc Med. .

Abstract

Introduction: Concomitant COPD and CVD are highly prevalent and contribute to increased risk of hospitalizations, morbidity, and mortality, and impose a significant financial burden on healthcare systems. Diagnosis of COPD in patients with comorbid CVD and vice versa is challenging due to an overlap between the risk factors and symptoms of these two conditions. This 8-member task force comprising pulmonologists and cardiologists agreed that in the UAE, while COPD patients suspected of having CVD are promptly referred to cardiology, CVD patients who may potentially also have COPD are often not referred or referred late from cardiology to pulmonology. This gap in identifying CVD patients who may potentially also have COPD must be addressed to facilitate referrals of such patients to pulmonology.

Methods and results: A task force comprising an equal number of cardiologists and pulmonologists met virtually and identified the gaps in current practices for diagnosing patients with comorbid COPD and CVD in the UAE. The task force has proposed an algorithm to expedite the referral of CVD patients suspected of COPD from cardiology to pulmonology.

Conclusion: Implementing this referral algorithm across all cardiology departments in the UAE can facilitate the diagnosis of COPD in CVD patients, allow timely treatment of COPD, and improve patient outcomes.

Keywords: COPD; United Arab Emirates; cardiologists; cardiovascular; collaboration; pulmonologists.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Prevalence of different CVDs in COPD patients. CVD, cardiovascular disease; COPD, chronic obstructive pulmonary disease. Adapted with permission from: Chen et al. (15).
Figure 2
Figure 2
GOLD 2024-proposed COPD assessment tool. FEV1, forced expiratory volume in 1 s; FVC, forced vital capacity; mMRC, modified medical research council dyspnea scale (a questionnaire to measure breathlessness); CAT™: COPD assessment Test (8-item questionnaire to assess the health status of COPD patients). Adapted from: Global Initiative for Chronic Obstructive Lung Disease (1). http://goldcopd.org/2024-gold-report/ ©2023, 2024, Global Initiative for Chronic Obstructive Lung Disease, available from https://www.goldcopd.org, published in Deer Park, IL, USA.
Figure 3
Figure 3
Stable COPD treatment goals. Adapted with permission from: Global initiative for Chronic Obstructive Lung Disease (1). http://goldcopd.org/2024-gold-report/ ©2023, 2024, Global Initiative for Chronic Obstructive Lung Disease, available from https://www.goldcopd.org, published in Deer Park, IL, USA.
Figure 4
Figure 4
Initial pharmacological treatment based on GOLD group. Due to improved treatment adherence, single inhalers may be more effective and convenient to patients than multiple inhalers. Exacerbations: Number of Exacerbations/year. Eos: Blood eosinophil count (cells/ul); mMRC: Modified Medical Research Council dyspnea questionnaire; CAT™: COPD Assessment test™. Adapted from: Global Initiative for Chronic Obstructive Lung Disease (1). http://goldcopd.org/2024-gold-report/ ©2023, 2024, Global Initiative for Chronic Obstructive Lung Disease, available from https://www.goldcopd.org, published in Deer Park, IL, USA.
Figure 5
Figure 5
Referral algorithm for stable CVD patients with suspected COPD overlap.
See this image and copyright information in PMC

References

    1. Global Initiative for Chronic Obstructive Lung Disease. 2024 GOLD report (2024). Available at: https://goldcopd.org/2024-gold-report/ (Accessed April 26, 2024).
    1. World Health Organization (WHO). Chronic obstructive pulmonary disease (COPD) (2023). Available at: https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pul... (Accessed April 26, 2024).
    1. Adeloye D, Song P, Zhu Y, Campbell H, Sheikh A, Rudan I. Global, regional, and national prevalence of, and risk factors for, chronic obstructive pulmonary disease (COPD) in 2019: a systematic review and modelling analysis. Lancet Respir Med. (2022) 10(5):447–58. 10.1016/S2213-2600(21)00511-7 - DOI - PMC - PubMed
    1. Kong CW, Wilkinson TMA. Predicting and preventing hospital readmission for exacerbations of COPD. ERJ Open Res. (2020) 6(2):00325–2019. 10.1183/23120541.00325-2019 - DOI - PMC - PubMed
    1. Chen S, Kuhn M, Prettner K, Yu F, Yang T, Bärnighausen T, et al. The global economic burden of chronic obstructive pulmonary disease for 204 countries and territories in 2020–50: a health-augmented macroeconomic modelling study. Lancet Glob Health. (2023) 11(8):e1183–93. 10.1016/S2214-109X(23)00217-6 - DOI - PMC - PubMed

LinkOut - more resources