Burden of Specialist-Diagnosed Chronic Cough in Adults

Abstract Background The burden of chronic cough (CC) in patients seeking specialist care is infrequently researched. Objective To describe patient characteristics and disease burden associated with specialist-diagnosed CC. Methods Using administrative pharmacy and medical data, we identified patients ages 18–85 years with CC diagnosed by pulmonologists, allergists, otolaryngologists, or gastroenterologists. Patients were stratified into 4 subgroups based on presence or absence of common respiratory diseases or gastroesophageal reflux disease (GERD). Clinical features and healthcare resource utilization (HCRU) in the baseline and outcome years were compared between the CC subgroups. Also determined were the baseline factors associated with persistence of CC and a comparison of the CC cohort to a matched non-cough cohort. Results The 11,290 patients with specialist-diagnosed CC were about 61 years of age and 66.7% female. The CC cohort experienced frequent GERD (44.1%), asthma (31.2%), obesity (24.3%), upper airway cough syndrome (20.4%), common cough complications (19.4%), and hospitalizations (9.8%). The CC patients with both respiratory disease and GERD exhibited at baseline and follow-up: the most common cough comorbidities, higher HCRU, specialist care, dispensed respiratory and non-respiratory medications including proton pump inhibitors, antitussives, psychotherapeutics, oral corticosteroids and antibiotics than the other subgroups. A 40.6% persistence of CC occurred similarly between CC subgroups. Additionally, CC patients in the matched analysis also experienced significantly more comorbidities, laboratory evaluations, HRCU, and antitussives than non-cough patients. Conclusions Specialist-diagnosed CC was associated with considerable disease burden, particularly among those with both respiratory disease and GERD. Additionally, CC burden was more pronounced than in matched non-cough patients.