Department of Respiratory Therapy, Rady Faculty of Health Sciences, 8664Univeristy of Manitoba, Winnipeg, MB, Canada.
Department of family medicine, Rady faculty of Health Science, 8664University of Manitoba, Winnipeg, MB, Canada.
Chron Respir Dis. 2022 Jan-Dec;19:14799731221089319. doi: 10.1177/14799731221089319.
Cough is a common symptom in idiopathic interstitial lung diseases (ILDs), there is little information of its management in primary care. The objective of this study was to explore the frequency of cough-related consultations and the medications prescribed to patients with ILDs in primary care.
This retrospective cohort study used electronic medical records (EMR) from Manitoba primary care providers participating in the Manitoba Primary Care Research Network repository (2014-2019). Cough-related consults and the subsequent medications prescribed to patients with ILDs were identified in the EMR.
295 patients with ILDs were identified, 73 (25%) of them had 141 cough-related consultations (mean 1.9, SD 1.3) during the period studied. In 50 (35%) of the consultations, patients were prescribed one or more of the following: inhaled bronchodilators (34%), nasal corticoids (18%), codeine/opiates (18%), antibiotics (14%), inhaled corticoids (14%), proton pump inhibitors (8%), cough preparations (6%), antihistamines (4%), and oral corticoids (2%). 13 (26%) subsequent cough-related consultations were identified within 6 months, mainly among patients who were prescribed cough preparations, nasal corticoids, antihistamines, and antibiotics.
One-quarter of patients with ILDs consulted primary care due to cough, and about a third of them received a prescription to address potentially underlying causes of cough. Although further studies are required to explore the effect of the medications prescribed, recurrent cough consultations suggested that cough preparations, nasal corticoids, and antihistamines are among the least effective treatments. More research is needed to understand the causes and optimal treatment of cough in patients with ILDs.
咳嗽是特发性间质性肺疾病（ILDs）的常见症状，但在初级保健中，关于其管理的信息很少。本研究的目的是探讨初级保健中ILD 患者咳嗽相关咨询的频率以及为其开具的药物。
本回顾性队列研究使用了参与马尼托巴初级保健研究网络存储库（2014-2019 年）的马尼托巴初级保健提供者的电子病历（EMR）。在 EMR 中确定了ILD 患者的咳嗽相关咨询和随后开具的药物。
共确定了 295 名 ILD 患者，其中 73 名（25%）在研究期间进行了 141 次咳嗽相关咨询（平均 1.9 次，SD 1.3）。在 50 次（35%）咨询中，患者被开具了一种或多种以下药物：吸入性支气管扩张剂（34%）、鼻皮质类固醇（18%）、可待因/阿片类药物（18%）、抗生素（14%）、吸入皮质类固醇（14%）、质子泵抑制剂（8%）、咳嗽制剂（6%）、抗组胺药（4%）和口服皮质类固醇（2%）。在 6 个月内发现了 13 次（26%）随后的咳嗽相关咨询，主要发生在开具咳嗽制剂、鼻皮质类固醇、抗组胺药和抗生素的患者中。
四分之一的 ILD 患者因咳嗽而咨询初级保健，其中约三分之一的患者开具了潜在咳嗽病因的处方。尽管需要进一步研究来探讨开具药物的效果，但反复咳嗽咨询表明咳嗽制剂、鼻皮质类固醇和抗组胺药的疗效较差。需要进一步研究来了解 ILD 患者咳嗽的原因和最佳治疗方法。
