Chronic Obstructive Pulmonary Disease: How Can We Optimise Management of Cardiopulmonary Risk in the UK? (ID 636)
Department of Respiratory Medicine, Musgrove Park Hospital, Somerset NHS Foundation Trust, Taunton, Somerset, UK
Abstract
Introduction: Patients with chronic obstructive pulmonary disease (COPD) face heightened cardiopulmonary risk (i.e. the risk of serious respiratory and/or cardiovascular events), but specific strategies for addressing this in UK clinical practice are lacking.
Approach and Current Status: A UK-based multidisciplinary taskforce of 11 members, with specialists from primary and secondary care, including doctors, pharmacists and nurses, was formed and undertook a systematic literature review and modified Delphi consensus study to help establish a clinical pathway for managing cardiopulmonary risk in patients with COPD.1 Following three rounds of voting, refinement by the taskforce and one round of assessment by a wider group of 77 UK experts, consensus was achieved on 18 statements, including nine recommended actions (Table 1).
Key themes were: the healthcare burden of acute exacerbations of COPD (AECOPDs); healthcare resource utilisation; the association of AECOPDs and cardiopulmonary events; cardiopulmonary risk management; and guidance on optimising care of these patients. In patients with concomitant COPD and cardiovascular disease, management strategies did not typically integrate specialties or primary and secondary care.
The taskforce developed a Cardiopulmonary Risk Matrix to provide a clinical pathway framework supporting the recognition and management of cardiopulmonary risk in patients with COPD (Figure 1).
Lessons and Next Steps: Patients with COPD have increased mortality and frequent healthcare interactions, often related to cardiopulmonary events. Most UK guidelines focus on respiratory management of COPD exacerbations and lack strategies to address cardiopulmonary risk. There is a need for greater integration and optimisation of COPD care, and for new UK policies and clinical guidance. The Cardiopulmonary Risk Matrix is a necessary first step in signposting best practice. To this end, we aim to seek input and endorsement from relevant UK medical societies and professional organisations, and to work with them to disseminate a standard version of the matrix for healthcare professionals across the UK.
Reference
1. Shrikrishna D, et al. Int J Chron Obstruct Pulmon Dis. 2025;20:2073–2090
Funding: This work was funded by AstraZeneca
Conflicts of interest: All authors are members of the UK Cardiopulmonary Taskforce, which is sponsored by AstraZeneca.
DS has received consultancy and speaker fees from AstraZeneca, GSK, Boehringer Ingelheim, BMS, Sanofi, Regeneron, Chiesi, Pfizer, and TEVA. These are outside of the submitted work.
JS has received research grants from Chiesi Ltd and Menarini, and honoraria from AstraZeneca. These are outside of the submitted work.
BB has received honoraria from AstraZeneca, Chiesi, GlaxoSmithKline, Orion, Sanofi, and TEVA. She also reports board membership of Association of Respiratory Nurses, Executive Committee Member Primary Care Cardiovascular Society, President-Elect Primary Care Cardiovascular Society. These are outside of the submitted work.
SWD is a former employee of AstraZeneca during the conduct of the study and may hold stock and/or stock options in the company.
AP has received honoraria and speaker fees from AstraZeneca, Chiesi, and Sanofi. These are outside of the submitted work.
SR has received honoraria from AstraZeneca, Ferring, Accord, and Novartis and is employed as a Medical Advisor for Iowna Health. These are outside of the submitted work.
RS has received honoraria from AstraZeneca, Chiesi, GSK, PM Healthcare, Regeneron, Sanofi, and TEVA. These are outside of the submitted work.
CS has received honoraria from AstraZeneca, Bedfont Scientific, Chiesi, GSK, Orion, and Trudell. She was Trustee and previous policy lead for PCRS-UK, as well as current Vice Chair of Taskforce for Lung Health. These are outside of the submitted work.
RFS has received research grants/support from AstraZeneca and Cytosorbents; and personal fees from Abbott, Afortiori Development/Thrombolytic Science, Alfasigma, AstraZeneca, Boehringer Ingelheim/Lilly, Bristol Myers Squibb/Johnson & Johnson, Chiesi, Daiichi Sankyo, Idorsia, Novartis, Novo Nordisk, Pfizer, PhaseBio, and Tabuk. These are outside of the submitted work.
CJT has received consultancy and speaker fees from AstraZeneca, Bayer, Edwards, and Roche. These are outside of the submitted work.
RT has received honoraria from Abbott, Amarin, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Daiichi Sankyo, Edwards, Medtronic, Novartis, and Omron. RT is employed by AstraZeneca and may hold stock and/or stock options in the company. These are outside of the submitted work.
CPG has received grants or contracts from Alan Turing Institute, British Heart Foundation, National Institute for Health Research, Horizon 2020, Abbott Diabetes, Bristol Myers Squibb, European Society of Cardiology, as well as receiving consulting fees from AI Nexus, AstraZeneca, Amgen, Bayer, Bristol Myers Squibb, Boehringer Ingelheim, and CardioMatics, and honoraria from AstraZeneca, Boston Scientific, Menarini, Novartis, Raisio Group, Wondr Medical, Zydus, Chiesi, Daiichi Sankyo, GPRI Research B.V., Novartis, iRhythm, Organon, and The Phoenix Group. These are outside of the submitted work.
The authors report no other conflicts of interest in this work.
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