Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Department of Internal Medicine, and Graduate Institute of Clinical Medicine, National Taiwan University Hospital, Hsin-Chu Branch and National Taiwan University College of Medicine, Taipei, Taiwan.
Lung. 2022 Dec;200(6):725-736. doi: 10.1007/s00408-022-00586-3. Epub 2022 Nov 3.
This study aimed to understand the cough characteristics and health journeys among community-based chronic cough (CC) patients, and their characteristics associated with healthcare visits.
A population-based cross-sectional study was conducted in 2020, using the South Korea and Taiwan National Health and Wellness Survey (NHWS) and CC surveys. Patients with current CC were defined by daily coughing for > 8 weeks in the past 12 months and currently coughing at the time of survey. The survey items pertained to CC patients' treatment journey and cough characteristics.
Patients with current CC in South Korea and Taiwan, respectively, had cough duration for 3.45 ± 5.13 years and 5.75 ± 7.28 years and cough severity visual analogue scale (VAS) scores of 4.50 ± 2.15 and 4.46 ± 1.92 out of 0-10 scale, with 70.3% and 57.9% having spoken with a physician about cough. Compared to CC patients who had not visited healthcare professionals for cough, those who visited reported more severe cough (VAS: 3.89 ± 1.71 vs. 4.6 ± 2.02; p = 0.009), worse cough-specific quality of life (Leicester Cough Questionnaire: 16.20 ± 3.23 vs.13.45 ± 2.68, p < 0.001), greater symptom severity (Hull Airway Reflux Questionnaire: 16.73 ± 15.16 vs. 24.57 ± 13.38; p < 0.001), and more urinary incontinence (13.6 vs. 26.5%, p = 0.027). More than 50% of patients perceived cough medication(s) as not or a little useful and 25% felt their physicians did not well understand how CC impacts their life.
Cough is frequently severe and persistent among community-based CC patients. They experience several issues in their health journey, including treatment ineffectiveness and physician's understanding. Further efforts are warranted to reduce CC burden in the community.
本研究旨在了解社区慢性咳嗽(CC)患者的咳嗽特征和健康历程,以及与就医相关的特征。
本研究采用 2020 年韩国和中国台湾全国健康和健康调查(NHWS)和 CC 调查进行了一项基于人群的横断面研究。当前患有 CC 的患者定义为过去 12 个月中每日咳嗽>8 周且在调查时当前正在咳嗽。调查项目涉及 CC 患者的治疗历程和咳嗽特征。
韩国和中国台湾当前患有 CC 的患者的咳嗽持续时间分别为 3.45±5.13 年和 5.75±7.28 年,咳嗽严重程度视觉模拟量表(VAS)评分为 4.50±2.15 和 4.46±1.92(0-10 分制),分别有 70.3%和 57.9%的患者曾就咳嗽问题与医生交谈过。与未因咳嗽而就医的 CC 患者相比,就医患者报告的咳嗽更严重(VAS:3.89±1.71 对 4.6±2.02;p=0.009),咳嗽特异性生活质量更差(莱斯特咳嗽问卷:16.20±3.23 对 13.45±2.68,p<0.001),症状严重程度更大(赫尔气道反流问卷:16.73±15.16 对 24.57±13.38;p<0.001),尿失禁发生率更高(13.6%对 26.5%,p=0.027)。超过 50%的患者认为咳嗽药物(s)无效或效果不大,25%的患者认为医生对 CC 如何影响他们的生活了解不足。
社区中 CC 患者的咳嗽常严重且持续。他们在健康历程中经历了多个问题,包括治疗效果不佳和医生对疾病的理解不足。需要进一步努力来减轻社区中的 CC 负担。