Evaluation of Cough Medication Use Patterns in Ambulatory Care Settings in the United States: 2003–2018

Abstract

Using 2003–2018 National Ambulatory Medical Care Survey data for office-based visits and 2003–2018 National Hospital Ambulatory Medical Care Survey data for emergency department (ED) visits, we conducted cross-sectional analyses to examine cough medication (CM) use trends in the United States (US) ambulatory care settings. We included adult (≥18 years) patient visits with respiratory-infection-related or non-infection-related cough as reason-for-visit or diagnosis without malignant cancer or benign respiratory tumor diagnoses. Using multivariable logistic regressions, we examined opioid antitussive, benzonatate, dextromethorphan-containing antitussive, and gabapentinoid use trends. From 2003–2005 to 2015–2018, opioid antitussive use decreased in office-based visits (8.8% to 6.4%, Ptrend = 0.03) but remained stable in ED visits (6.3% to 5.9%, Ptrend = 0.99). In both settings, hydrocodone-containing antitussive use declined over 50%. Benzonatate use more than tripled (office-based:1.6% to 4.8%; ED:1.5% to 8.0%; both Ptrend < 0.001). Dextromethorphan-containing antitussive use increased in ED visits (1.8% to 2.6%, Ptrend = 0.003) but stayed unchanged in office-based visits (3.8% to 2.7%; Ptrend = 0.60). Gabapentinoid use doubled in office-based visits (1.1% in 2006–2008 to 2.4% in 2015–2018, Ptrend < 0.001) but was negligible in ED visits. In US office-based and ED ambulatory care settings, hydrocodone-containing antitussive use substantially declined from 2003 to 2018, while benzonatate use more than tripled, and dextromethorphan-containing antitussive and gabapentinoid use remained low (<3%).

Patterns of Cough Medication Prescribing among Patients with Chronic Cough in Florida: 2012–2021

“…We observed similar trends among non-CC patients with any cough-related diagnosis with an overall lower CM prescribing prevalence. The observed substantial increase in benzonatate use in Florida is consistent with previous studies conducted in the US using nationally representative data [39,40].…”

Benzonatate Safety and Effectiveness: A Systematic Review of the Literature

“…Most studies selected were cohort studies published from 1956 to 2022. 20 -40 The cohort studies were published from Italy, 20,26-28,32,34,41 Switzerland, 21 the United States, 23-25,35-40,42 Canada, 29 Germany, 30 and Austria. 31 The primary focus of the studies was the assessment of effectiveness only, 21,22,24,26,27,29,31-33,35,36 safety only 37-39,42 effectiveness and safety, 20,23,25,28,30,34 tolerability, 22 dosing, 34 and utilization.…”

“…31 The primary focus of the studies was the assessment of effectiveness only, 21,22,24,26,27,29,31-33,35,36 safety only 37-39,42 effectiveness and safety, 20,23,25,28,30,34 tolerability, 22 dosing, 34 and utilization. 40 The indications of interest were cough, 20,23,26-30,32,33,36,40,42,43 tuberculosis, 21,29,31 bronchitis, 22,33,34 pulmonary emphysema or malignancies, 24,25,34 severe gag reflexes, 35 and benzonatate ingestion or overdose. 37-39 Included formulations of benzonatate include perles, 20-22,26,28,32 intramuscular injection, 20,24,28,31,…”

“…In the quality assessments, biases associated with sequences generation, allocation concealment, and blinding of participants, personnel, and outcome assessment were not applicable for most studies because they were not randomized. 20-40,42,43 Many cohort studies had low risks of incomplete data and selective reporting given the short follow-up period and data collection process. The potential of other sources of biases was high and was primarily related to the limited sample size, data collection, generalizability, and study design.…”

Аналіз Асортименту Лікарських Засобів Для Лікування Кашлю

“…У No 151 як у моноскладі, так і в його комплексному поєднанні з іншими субстанціями [5,11]. Ця тенденція має місце у всьому світі, незалежно від того, чи є терапія лікарськими рослинами в окремих країнах історично обумовленою чи результатом новітніх наукових досліджень, що пояснюється широким спектром їх біологічного впливу, через наявність у складі комплексів основних речовин із супутніми речовинами, що посилюють їх біологічну активність, низькою токсичністю, біодоступністю, можливістю тривалого застосування без виникнення побічних явищ та м'якістю дії [12].…”