The Healthcare Resource Utilization of Patients with Refractory Chronic Cough Compared to Those with Non-Refractory Chronic Cough.

BACKGROUND

Refractory chronic cough (RCC) significantly impairs patient quality of life and poses a major challenge in clinical management. However, little is known about the healthcare resource utilization (HRU) of patients with RCC.

OBJECTIVE

The goal of our study is to describe the HRU and associated costs of RCC patients and those with non-refractory chronic cough (non-RCC).

METHODS

Patients with chronic cough were prospectively recruited from 6 centers in France. At 6 months, the patients were classified as having RCC or no RCC. A retrospective analysis was made using the French National Health Insurance Database (SNDS) in order to determine healthcare utilization for the one-year period preceding inclusion at the site and for the one-year period thereafter.

RESULTS

Sixty-eight patients were included. Among them, 32 (47%) patients had RCC. There was no difference between groups regarding clinical data apart from cough duration (56.8 ± 59.5 months in the no RCC group vs. 139.3 ± 123.8 months in the RCC group, p = 0.002). Within 1 year prior to inclusion, there was no difference in terms of drug dispensations between the 2 groups. During the 1-year post-inclusion period, a significantly higher proportion of patients with RCC received at least one dispensation of opioids and amitriptyline compared to those with no RCC (8 (25%) vs. 2 (6%) for opioids, p = 0.038 and 14 (44%) vs. 3 (8%) for amitriptyline, p = 0.0015, respectively). Within 1 year after inclusion, more patients with RCC had attended speech pathologist visits in comparison to patients with no RCC (14 (44%) patients vs. 10 (28%) patients, p = 0.21, respectively). Total costs within 12 months prior to inclusion were 3,878€ [2,498 - 5,755€] for patients with no RCC and 5,159€ [3,426 - 7,138€] with RCC, but the difference was not significant. No change occurred in the 1-year period following inclusion.

CONCLUSION

RCC has a high healthcare utilization with substantial costs.