Evaluation of healthcare utilization and burden of chronic cough in Taiwan using patient interviews and medical chart review

BACKGROUND/PURPOSE: The estimated prevalence of chronic cough, defined as coughing for >8 weeks, in Taiwan was 8%. However, the understanding of its clinical and healthcare burden in Taiwan is limited. METHODS: This multicenter observational study enrolled 200 patients with >8 weeks' daily coughing across five medical centers in Taiwan (November 2020-November 2022). Patient demographics, disease-related characteristics, health-related quality of life (HRQoL) and healthcare resource utilization (HCRU) were collected prospectively through patient interviews and questionnaires. Medical history, diagnostic test, and medications used in the past 12 months were collected retrospectively through medical chart review. RESULTS: The mean age was 55.1 years, 60.0% were females and 85.0% were non-smokers. Cough severity was 52.6. The mean duration since symptoms onset was 3.6 years. Among participants, 33.0% reported sleep disturbances (N = 66) and 19.7% of them experienced severe-to-very-severe disturbances. Among 113 participants with cough-related complications, 46.0% had chest pains, 25.6% had anxiety, and 23.0% had urinary incontinence, while 158 (78.0%) reported respiratory-related complications. Antitussives and expectorants, antihistamines, and nasal inhalers were the most commonly used medications. Traditional medicine usage was reported by 31.4% through patient interviews. Most participants had HCRU (85.5%), underwent chest x-ray (∼95%) and pulmonary function tests (∼60%). Self-paid monthly medical and over-the-counter treatment costs were approximately US$94/patient and US$14/patient, respectively. Sleep disturbances and cough severity negatively impacted the HRQoL. CONCLUSION: Chronic cough poses a substantial impact on HCRU, economic costs and HRQoL in Taiwan, suggesting a need for innovative therapeutic strategies to effectively manage chronic cough in the clinical setting in Taiwan.