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- Title
Management and referral patterns for new-onset chronic cough in primary care patients.
- Authors
Ringus, Daina L.; Li, Sylvia H.; Vu, Thanh-Huyen T.; Guo, Amina; Yuksel, Selcen; Arch, Rebecca S.; Patel, Amee K.; Patel, Gayatri B.; Peters, Anju T.
- Abstract
Background: The diagnosis and management of chronic cough in primary care is challenging despite it being one of the most common chronic conditions. Objective: Clinical characterization of patients with new-onset chronic cough in the primary care setting. Methods: This was a retrospective study of adult patients (ages ≥ 18 years) with at least three visits with primary care providers (PCP) for new-onset cough, with at least 8 weeks between the first and third visits, within a tertiary-care center and affiliated clinics between January 1, 2010, and January 1, 2019 (N = 174). We calculated the frequency of primary care visits, diagnostic testing, specialist referrals, and prescribed medications up to 18 months after the third visit with a PCP for cough. Results: Of 174 patients who met the criteria of new-onset chronic cough, >50% had four or more primary care visits related to cough. Despite that, 91 (52.3%) did not receive a referral to a specialist, and 41 (23.5%) did not receive an order for a chest radiograph during the evaluation of the chronic cough. Antibiotics and systemic corticosteroids were prescribed to 106 (61%) and 63 (36%) of the patients, respectively, and 20% were prescribed opiates. No patients were prescribed central-neuromodulating agents, and angiotensin-converting enzyme inhibitors were discontinued in 48% of the patients who were taking them (12/25). Conclusion: We found considerable heterogeneity and discrepancies with clinical guideline recommendations in patients who presented with new chronic cough. There is a substantial unmet need to study chronic cough in the primary care setting to inform important stakeholders.
- Subjects
COUGH; PRIMARY care; ACE inhibitors; PATIENT care; CHEST X rays
- Publication
Allergy & Asthma Proceedings, 2022, Vol 43, Issue 6, pe72
- ISSN
1088-5412
- Publication type
Article
- DOI
10.2500/aap.2022.43.220071