Management and referral patterns for new-onset chronic cough in primary care patients.
Allergy Asthma Proc
; 43(6): e72-e79, 2022 11 01.
Article
em En
| MEDLINE
| ID: mdl-36335417
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.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Encaminhamento e Consulta
/
Tosse
Tipo de estudo:
Diagnostic_studies
/
Guideline
/
Observational_studies
Limite:
Adolescent
/
Adult
/
Humans
Idioma:
En
Revista:
Allergy Asthma Proc
Assunto da revista:
ALERGIA E IMUNOLOGIA
Ano de publicação:
2022
Tipo de documento:
Article