Cough Characteristics and Healthcare Journeys of Chronic Cough Patients in Community-Based Populations in South Korea and Taiwan

Abstract

Purpose 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. Methods 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. Results 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. Conclusion 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.

Codeine prescription pattern and treatment responses in patients with chronic cough: a routinely collected institutional database analysis

“…In an analysis of a Midwestern academic medical institutional EHRs, US, opioid-containing cough suppressants were prescribed to 22.0% of patients with chronic cough and the odds ratio for at least one prescription was 2.9 for patients with chronic cough ( vs. non-chronic cough controls) ( 22 ). Similar prescription rates were reported from community-based populations of South Korea and Taiwan (11.9% and 28.2%, respectively) ( 12 ), but also a much higher rate reported from specialist clinics (pulmonologists, allergists, otolaryngologists, or gastroenterologists) in Southern California, US (58.9%) ( 11 ). The higher codeine prescription rates at specialist clinics (including the present study) may be attributed to healthcare journey or prior insufficient treatment responses of patients before visiting the referral centers ( 23 ).…”

“…In a recent retrospective administrative pharmacy and medical database analysis, antitussives including codeine were prescribed in 58.9% of chronic cough patients at specialist clinics in Southern California, US ( 11 ). The use of codeine- or hydrocodone-containing drugs was reported by 11.9% and 28.2% of chronic cough patients in community-based populations of South Korea and Taiwan, respectively ( 12 ). However, a prescription pattern of codeine, such as dose or treatment duration, has not been reported in detail.…”

Healthcare-Seeking Behaviour Due to Cough in Finnish Elderly: Too Much and Too Little

“…Both conditions are also characterised by exacerbations which are often treated with prescription drugs, and this may partly explain their associations with repeated visits. The important role of quality-of-life in healthcare use and costs due to cough has been recognised also previously [ 4 , 17 , 18 ]. Routine quality-of-life assessment, as recommended in guidelines [ 14 , 19 ], may help to detect potential “high-cost patients” due to cough.…”

LUNG Year in Review: 2022

“…Indeed, 2022 witnessed the approval of the first-ever drug indicated for the treatment of refractory chronic cough [ 51 , 52 ]. LUNG continued its emphasis on high-quality cough-related research by featuring numerous articles, including those examining asthma-associated cough [ 21 , 22 ]; cough associated with IPF [ 53 ] and COVID19 [ 54 ]; methodology of objective cough counting [ 55 , 56 ]; cough-related healthcare utilization [ 57 , 58 ]; physiology [ 59 ]; and, studies of potential antitussive drugs [ 60 – 62 ].…”