Yu Chong-Jen, Song Woo-Jung, Kang Suk Hyun
Department of Internal Medicine, and Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.
Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
World Allergy Organ J. 2022 Sep 5;15(9):100681. doi: 10.1016/j.waojou.2022.100681. eCollection 2022 Sep.
Chronic cough (CC) is a common condition, but the burden of CC in general populations remains largely unknown. This study aims to investigate the disease prevalence and burden among community-based CC patients in South Korea and Taiwan, using structured tools.
A population-based cross-sectional study uses data from the 2020 South Korea and Taiwan National Health and Wellness Survey (NHWS) as well as a CC survey conducted between January-February 2020 and March-April 2020, respectively. Health outcome measures included health-related quality of life (HRQoL), health state utilities, work productivity and activity impairment (WPAI), and measurement of depression, anxiety, and insomnia among CC patients.
The weighted lifetime and 12-month prevalence of CC was 6.20% and 4.34% in South Korea, and 8.27% and 5.55% in Taiwan. Compared to matched non-CC controls, CC patients reported poorer HRQoL (SF-12v2) in terms of physical component summary (PCS) score (South Korea: 47.69 ± 7.68 vs. 50.08 ± 7.29; Taiwan: 48.58 ± 7.15 vs. 50.50 ± 7.30) and mental component summary (MCS) score (44.15 ± 8.85 vs. 46.28 ± 8.50; 42.44 ± 7.78 vs. 44.60 ± 8.08), health state utilities EQ-5D index (0.73 ± 0.23 vs. 0.82 ± 0.16; 0.82 ± 0.13 vs. 0.86 ± 0.14), and more visits to healthcare professionals (7.80 vs. 4.61; 6.09 vs. 4.20) (p < 0.05). In terms of WPAI, CC patients reported higher impairments in presenteeism (32.8% vs. 21.0%; 25.9% vs. 19.4%), total work productivity (36.2% vs. 22.3%; 27.7% vs. 20.6%), and total activity (34.2% vs. 23.2%; 27.7% vs. 20.3%) than non-CC controls (p < 0.001). CC patients in South Korea and Taiwan experienced anxiety, depression, and insomnia more than non-CC controls. Poorer health outcomes were associated with the severity of CC. Patients with severe CC (visual analogue scale [VAS]>4) in both nations reported lower PCS score (45.80 vs. 49.48; 47.41 vs. 49.22) and higher absenteeism (8.5% vs. 3.6%; 5.5% vs. 1.8%) than patients with mild CC (VAS≤4) (p < 0.05).
The findings revealed that the disease burden of CC in general populations of South Korea and Taiwan is considerable with a negative impact on the overall quality of life, social and work life, and psychological comorbidities and is significantly associated with increased severity of the CC. There is an unmet need for further treatment interventions for CC patients to relieve the burden of CC in both nations.
慢性咳嗽(CC)是一种常见病症,但普通人群中CC的负担在很大程度上仍不为人知。本研究旨在使用结构化工具调查韩国和台湾地区社区CC患者的疾病患病率和负担。
一项基于人群的横断面研究使用了2020年韩国和台湾地区国民健康与福祉调查(NHWS)的数据,以及分别在2020年1月至2月和2020年3月至4月进行的CC调查数据。健康结局指标包括健康相关生活质量(HRQoL)、健康状态效用、工作生产力和活动障碍(WPAI),以及CC患者的抑郁、焦虑和失眠测量。
CC的加权终生患病率和12个月患病率在韩国分别为6.20%和4.34%,在台湾地区分别为8.27%和5.55%。与匹配的非CC对照组相比,CC患者在身体成分总结(PCS)评分方面的HRQoL(SF - 12v2)较差(韩国:47.69±7.68 vs. 50.08±7.29;台湾:48.58±7.15 vs. 50.50±7.30),在精神成分总结(MCS)评分方面也较差(44.15±8.85 vs. 46.28±8.50;42.44±7.78 vs. 44.60±8.08),健康状态效用EQ - 5D指数较低(0.73±0.23 vs. 0.82±0.16;0.82±0.13 vs. 0.86±0.14),并且就医次数更多(7.8 vs. 4.61;6.09 vs. 4.20)(p < 0.05)。在WPAI方面,CC患者在出勤障碍(32.8% vs. 21.0%;25.9% vs. 19.4%)、总工作生产力(36.2% vs. 22.3%;27.7% vs. 20.6%)和总活动(34.2% vs. 23.2%;27.7% vs. 20.3%)方面的障碍高于非CC对照组(p < 0.001)。韩国和台湾地区的CC患者比非CC对照组更容易出现焦虑、抑郁和失眠。较差的健康结局与CC的严重程度相关。两个地区中重度CC(视觉模拟量表[VAS]>4)患者的PCS评分较低(45.80 vs. 49.48;47.41 vs. 49.22),缺勤率较高(8.5% vs. 3.6%;5.5% vs. 1.8%),而轻度CC(VAS≤4)患者则不然(p < 0.05)。
研究结果显示,韩国和台湾地区普通人群中CC的疾病负担相当大,对整体生活质量、社会和工作生活以及心理合并症产生负面影响,并且与CC严重程度增加显著相关。在这两个地区,CC患者对进一步治疗干预以减轻CC负担的需求尚未得到满足。