Servicio de Alergia, Departamento de Ciencias Biomédicas Y del Diagnóstico, Facultad de Medicina, Hospital Universitario de Salamanca, Universidad de Salamanca, Salamanca, Spain.
Servicio de Neumología, Hospital Universitario Gregorio Marañón- Universidad Complutense, Madrid, Spain.
Lung. 2023 Jun;201(3):275-286. doi: 10.1007/s00408-023-00620-y. Epub 2023 May 9.
Chronic cough (cough that persists for ≥ 8 weeks) can cause a range of physical symptoms and psychosocial effects that significantly impair patients' quality of life. Refractory chronic cough (RCC) and unexplained chronic cough (UCC) are challenging to diagnose and manage, with substantial economic implications for healthcare systems.
This retrospective multicenter non-interventional study aimed to characterize the profile and health resource consumption of patients with RCC or UCC who attended outpatient clinics at Spanish hospitals. Data were collected from medical records of patients with RCC or UCC for up to 3 years before study inclusion.
The patient cohort (n = 196) was representative of the chronic cough population (77.6% female, mean age 58.5 years). Two-thirds of patients (n = 126) had RCC. The most frequently visited doctors were pulmonologists (93.4% of patients) and primary care physicians (78.6%), with a mean of 5 visits per patient over three years' observation. The most common diagnostic tests were chest x-ray (83.7%) and spirometry with bronchodilation (77.0%). The most commonly prescribed treatments were proton pump inhibitors (79.6%) and respiratory medications (87.8%). Antibiotics were prescribed empirically to 56 (28.6%) patients. Differences between RCC or UCC groups related mainly to approaches used to manage cough-associated conditions (gastroesophageal reflux disease, asthma) in patients with RCC.
RCC and UCC are responsible for high health resource utilization in Spanish hospitals. Specific treatments targeting the pathological processes driving chronic cough may provide opportunities to reduce the associated burden for patients and healthcare systems.
慢性咳嗽(持续时间≥8 周的咳嗽)可引起一系列身体症状和心理社会影响,显著降低患者的生活质量。难治性慢性咳嗽(RCC)和不明原因的慢性咳嗽(UCC)的诊断和治疗具有挑战性,对医疗保健系统有重大的经济影响。
本回顾性多中心非干预性研究旨在描述在西班牙医院门诊就诊的 RCC 或 UCC 患者的特征和卫生资源消耗情况。在研究纳入前,从 RCC 或 UCC 患者的病历中收集了长达 3 年的数据。
患者队列(n=196)具有慢性咳嗽人群的代表性(77.6%为女性,平均年龄 58.5 岁)。三分之二的患者(n=126)患有 RCC。就诊最多的医生是肺科医生(93.4%的患者)和初级保健医生(78.6%),在三年的观察期间,每位患者平均就诊 5 次。最常见的诊断测试是胸部 X 射线(83.7%)和支气管扩张后的肺功能检查(77.0%)。最常开的治疗药物是质子泵抑制剂(79.6%)和呼吸系统药物(87.8%)。经验性地给 56 名(28.6%)患者开了抗生素。RCC 和 UCC 组之间的差异主要与 RCC 患者咳嗽相关疾病(胃食管反流病、哮喘)的管理方法有关。
RCC 和 UCC 导致西班牙医院卫生资源的大量消耗。针对慢性咳嗽驱动病理过程的特定治疗方法可能为减轻患者和医疗保健系统的相关负担提供机会。