Burden and impact of chronic cough in UK primary care: a dataset analysis

Objective Chronic cough (CC) is a debilitating respiratory symptom, now increasingly recognised as a discrete disease entity. This study evaluated the burden of CC in a primary care setting.Design Cross-sectional, retrospective cohort study.Setting Discover dataset from North West London, which link...

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Main Authors: James H Hull, Mark L Levy, Haya Langerman, Tahereh Kamalati, Amanda Lucas
Format: Article
Language:English
Published: BMJ Publishing Group 2021-12-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/11/12/e054832.full
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author James H Hull
Mark L Levy
Haya Langerman
Tahereh Kamalati
Amanda Lucas
author_facet James H Hull
Mark L Levy
Haya Langerman
Tahereh Kamalati
Amanda Lucas
author_sort James H Hull
collection DOAJ
description Objective Chronic cough (CC) is a debilitating respiratory symptom, now increasingly recognised as a discrete disease entity. This study evaluated the burden of CC in a primary care setting.Design Cross-sectional, retrospective cohort study.Setting Discover dataset from North West London, which links coded data from primary and secondary care. The index date depicted CC persisting for ≥8 weeks and was taken as a surrogate for date of CC diagnosis.Participants Data were extracted for individuals aged ≥18 years with a cough persisting ≥8 weeks or cough remedy prescription, between Jan 2015 and Sep 2019.Main outcome measures Demographic characteristics, comorbidities and service utilisation cost, including investigations performed and treatments prescribed were determined.Results CC was identified in 43 453 patients from a total cohort of 2 109 430 (2%). Median (IQR) age was 64 years (41–87). Among the cohort, 31% had no recorded comorbidities, 26% had been given a diagnosis of asthma, 17% chronic obstructive pulmonary disease, 12% rhinitis and 15% reflux. Prevalence of CC was greater in women (57%) and highest in the 65–74 year age range. There was an increase in the number of all investigations performed in the 12 months before and after the index date of CC diagnosis, and in particular for primary care chest X-ray and spirometry which increased from 6535 to 12 880 and from 5791 to 8720, respectively. This was accompanied by an increase in CC-associated healthcare utilisation costs.Conclusion One-third of individuals had CC in the absence of associated comorbidities, highlighting the importance of recognising CC as a condition in its own right. Overall outpatient costs increased in the year after the CC index date for all comorbidities, but varied significantly with age. Linked primary-care datasets may enable earlier detection of individuals with CC for specialist clinic referral and targeted treatment.
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spelling doaj-art-0e6e5c6a67f944ff8f8891343d7ca1902024-12-10T17:05:11ZengBMJ Publishing GroupBMJ Open2044-60552021-12-01111210.1136/bmjopen-2021-054832Burden and impact of chronic cough in UK primary care: a dataset analysisJames H Hull0Mark L Levy1Haya Langerman2Tahereh Kamalati3Amanda Lucas4UK Sports Institute, Manchester, UKsenior clinical research fellowMSD, London, UKImperial College Health Partners, London, UKImperial College Health Partners, London, UKObjective Chronic cough (CC) is a debilitating respiratory symptom, now increasingly recognised as a discrete disease entity. This study evaluated the burden of CC in a primary care setting.Design Cross-sectional, retrospective cohort study.Setting Discover dataset from North West London, which links coded data from primary and secondary care. The index date depicted CC persisting for ≥8 weeks and was taken as a surrogate for date of CC diagnosis.Participants Data were extracted for individuals aged ≥18 years with a cough persisting ≥8 weeks or cough remedy prescription, between Jan 2015 and Sep 2019.Main outcome measures Demographic characteristics, comorbidities and service utilisation cost, including investigations performed and treatments prescribed were determined.Results CC was identified in 43 453 patients from a total cohort of 2 109 430 (2%). Median (IQR) age was 64 years (41–87). Among the cohort, 31% had no recorded comorbidities, 26% had been given a diagnosis of asthma, 17% chronic obstructive pulmonary disease, 12% rhinitis and 15% reflux. Prevalence of CC was greater in women (57%) and highest in the 65–74 year age range. There was an increase in the number of all investigations performed in the 12 months before and after the index date of CC diagnosis, and in particular for primary care chest X-ray and spirometry which increased from 6535 to 12 880 and from 5791 to 8720, respectively. This was accompanied by an increase in CC-associated healthcare utilisation costs.Conclusion One-third of individuals had CC in the absence of associated comorbidities, highlighting the importance of recognising CC as a condition in its own right. Overall outpatient costs increased in the year after the CC index date for all comorbidities, but varied significantly with age. Linked primary-care datasets may enable earlier detection of individuals with CC for specialist clinic referral and targeted treatment.https://bmjopen.bmj.com/content/11/12/e054832.full
spellingShingle James H Hull
Mark L Levy
Haya Langerman
Tahereh Kamalati
Amanda Lucas
Burden and impact of chronic cough in UK primary care: a dataset analysis
BMJ Open
title Burden and impact of chronic cough in UK primary care: a dataset analysis
title_full Burden and impact of chronic cough in UK primary care: a dataset analysis
title_fullStr Burden and impact of chronic cough in UK primary care: a dataset analysis
title_full_unstemmed Burden and impact of chronic cough in UK primary care: a dataset analysis
title_short Burden and impact of chronic cough in UK primary care: a dataset analysis
title_sort burden and impact of chronic cough in uk primary care a dataset analysis
url https://bmjopen.bmj.com/content/11/12/e054832.full
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AT taherehkamalati burdenandimpactofchroniccoughinukprimarycareadatasetanalysis
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