Department of Medicine, McMaster University, Hamilton, ON, Canada.
Division of Respirology, McMaster University, Hamilton, ON, Canada.
Lung. 2023 Feb;201(1):47-55. doi: 10.1007/s00408-023-00604-y. Epub 2023 Feb 18.
Educational programs on chronic cough may improve patient care, but little is known about how Canadian physicians manage this common debilitating condition. We aimed to investigate Canadian physicians' perceptions, attitudes, and knowledge of chronic cough.
We administered a 10-min anonymous, online, cross-sectional survey to 3321 Canadian physicians in the Leger Opinion Panel who managed adult patients with chronic cough and had been in practice for > 2 years.
Between July 30 and September 22, 2021, 179 physicians (101 general practitioners [GPs] and 78 specialists [25 allergists, 28 respirologists, and 25 ear/nose/throat specialists]) completed the survey (response rate: 5.4%). In a month, GPs saw a mean of 27 patients with chronic cough, whereas specialists saw 46. About one-third of physicians appropriately identified a duration of > 8 weeks as the definition for chronic cough. Many physicians reported not using international chronic cough management guidelines. Patient referrals and care pathways varied considerably, and patients frequently experienced lost to follow-up. While physicians endorsed nasal and inhaled corticosteroids as common treatments for chronic cough, they rarely used other guideline-recommended treatments. Both GPs and specialists expressed high interest in education on chronic cough.
This survey of Canadian physicians demonstrates low uptake of recent advances in chronic cough diagnosis, disease categorization, and pharmacologic management. Canadian physicians also report unfamiliarity with guideline-recommended therapies, including centrally acting neuromodulators for refractory or unexplained chronic cough. This data highlights the need for educational programs and collaborative care models on chronic cough in primary and specialist care.
慢性咳嗽的教育项目可能会改善患者的护理，但对于加拿大医生如何管理这种常见的使人衰弱的疾病知之甚少。我们旨在调查加拿大医生对慢性咳嗽的看法、态度和知识。
我们向 Leger Opinion Panel 中的 3321 名管理成年慢性咳嗽患者且从业时间超过 2 年的加拿大医生进行了一项 10 分钟的匿名在线横断面调查。
2021 年 7 月 30 日至 9 月 22 日，179 名医生（101 名全科医生[GP]和 78 名专科医生[25 名过敏科医生、28 名呼吸科医生和 25 名耳鼻喉科医生]）完成了调查（应答率：5.4%）。一个月内，GP 平均看诊 27 名慢性咳嗽患者，而专科医生看诊 46 名。约三分之一的医生正确地将持续时间超过 8 周作为慢性咳嗽的定义。许多医生表示不使用国际慢性咳嗽管理指南。患者转诊和护理途径差异很大，患者经常失访。虽然医生认可鼻内和吸入皮质类固醇是慢性咳嗽的常见治疗方法，但他们很少使用其他指南推荐的治疗方法。GP 和专科医生都对慢性咳嗽教育表现出浓厚的兴趣。
这项对加拿大医生的调查表明，在慢性咳嗽的诊断、疾病分类和药物治疗方面，最新进展的采用率较低。加拿大医生还报告称不熟悉指南推荐的治疗方法，包括对难治性或不明原因的慢性咳嗽使用中枢作用的神经调节剂。这些数据突出了在初级和专科护理中开展慢性咳嗽教育项目和协作护理模式的必要性。
