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Chronic cough as seen by allergy specialists: An internet survey of providers in a large nation-wide practice

Journal: Allergy and Asthma Proceedings Date: 2022/06, 43(2):Pages: 174, type of study: cross sectional study

Full text    (https://www.ingentaconnect.com/contentone/ocean/aap/2022/00000043/00000002/art00013)

Keywords:

chronic cough [2]
health survey [4]
osteopathic physicians [163]
medical physicians [7]
nurse practitioner [2]
allergy [10]
corticosteroid [4]
antihistaminic agent [1]
conference abstract [108]
cross sectional study [597]

Abstract:

Statement of purpose: Chronic cough (CC) affects over 11% of the U.S. adult population resulting in disruptions in physical, psychological and social health. A significant proportion of CC patients experience persistent symptoms despite adherence to recommended treatment. Further research is needed to identify the efficacy of current therapies to treat CC adults. The purpose of this study was to describe the prevalence of symptoms and the efficacy of treatments for patients diagnosed with chronic cough who presented to allergy specialists (AS). Statement of methods: A cross-sectional descriptive survey design involved administering an online survey at a single time to 177 AS including MDs, DOs (Doctor of Osteopathic Medicine), PAs (Physicians Assistants) and NPs (Nurse Practitioners) anonymously over an online platform. The survey queried each AS experiences with chronic cough patients, the prevalence of chronic cough symptoms and their perceived efficacy of commonly employed treatments. Summary of results: 103 (58%)AS responded to the survey. The average age of the AS respondents was 47610.83 years, who reported practicing in the specialty area for an average of 14.47610.18 years. A majority (82.4%) of the sample were physicians (MD or DO), with 17.6% of the sample being PAs or NPs. Of this sample, all but 2% reported having training in allergy medicine. A majority (83.3%) of the providers in the sample treated more than 10 CC patients in the previous 12 months. The providers in the study reported 56.8% of their CC patients being diagnosed with refractory chronic cough (RCC), 33.1% with unexplained chronic cough (UCC) and the remaining 10.1% with CC of other type. The most common duration of the CC symptoms that their patients reported experiencing was 3-6 months (36.4%), with 25% of the patients reporting CC symptoms lasting 6-12 months and 22.2% reporting CC symptoms of 1-5 years. The duration of time the providers reported treating CC patients was less than one year (54.2%), 1 to 5 years (21.9%) and 5 or more years (23.9%). The top four 'very common complaints' reported by CC patients were social embarrassment, loss of sleep, decreased quality of life, and sleep disruption. The top four most frequent treatments prescribed for CC were anti-reflux treatments, inhaled corticosteroids (ICS) alone or in combination with long acting beta-agonist (LABA), short acting bronchodilators, and first generation antihistamines. None of the therapies were rated 'very effective' in greater than 50% of the CC patients treated by the AS. Discussion: These findings are consistent with the literature indicating that patients with CC experience unresolved symptoms the available treatments for CC do not effectively resolve the symptoms of this condition and additional treatments need to be developed and evaluated.


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