Chronic Obstructive Pulmonary Disease in the Gulf Cooperation Council: Acute-Care Utilization and Medication Adherence: A PRISMA-ScR Scoping Review.

Background

Chronic obstructive pulmonary disease (COPD) is a major contributor to morbidity, mortality, and healthcare utilization worldwide. In Gulf Cooperation Council (GCC) countries, the evidence on COPD-related acute-care utilization and medication adherence remains fragmented; hence, this scoping review aimed to map and characterize the available evidence.

Methods

This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. PubMed/MEDLINE, Embase, Scopus, Cochrane Library, and Google Scholar were searched from inception to 22 May 2026. Eligible studies reported COPD-related acute-care utilization and/or medication adherence outcomes in GCC countries. Two reviewers independently screened the studies, extracted the data, and assessed the methodological quality using Joanna Briggs Institute appraisal tools. The findings were synthesized narratively.

Results

The search identified 328 records, of which 15 studies were included. Most originated from Saudi Arabia, with retrospective cohort and cross-sectional designs predominating. A higher comorbidity burden, obesity, respiratory infection, and disease severity were associated with increased acute-care utilization. Poor medication adherence was associated with increased emergency department visits and hospitalizations. The emerging evidence highlights eosinophilic and obesity-associated COPD phenotypes as potential contributors to clinical outcomes.

Conclusions

Evidence on acute-care utilization and medication adherence among COPD populations in GCC countries remains limited and heterogeneous. The available studies suggest a healthcare burden, particularly among patients with severe exacerbations and multimorbidity. Future research should prioritize multicenter prospective studies, standardized outcome reporting, and interventions to improve medication adherence and decrease acute-care utilization.