The following is a summary of “An Observational Study to Understand Burden and Cost of Care in Adults Diagnosed with Refractory Chronic Cough (RCC) or Unexplained Chronic Cough (UCC),” published in the July 2024 issue of Pulmonology by Smith et al.

Refractory and unexplained chronic cough (RCC and UCC) necessitate frequent specialist evaluations, yet data on healthcare resource utilization and associated costs remain insufficient. This observational study aimed to bridge this gap by examining the healthcare burden and costs linked to RCC and UCC.

Researchers enrolled adults diagnosed with RCC or UCC from a specialist cough clinic in North West England, creating a control cohort matched 1:5 for age, gender, and smoking history. The study group collected primary and secondary care data spanning five years before and two years following the initial clinic visit (index date). The primary endpoint was the total five-year healthcare cost to the UK NHS pre-RCC or UCC diagnosis compared to the control cohort.

Among the 200 patients with RCC or UCC, the mean age at the index date was 62.2 ± 11.4 years; 71% were female, and 68% had never smoked. The mean duration of symptoms before diagnosis was 8.0 ± 9.4 years. At the index date, the mean cough severity score was 63.7 ± 23.2 mm on a Visual Analog Scale, and the Leicester Cough Questionnaire total score was 10.9 ± 4.1. General practitioner (GP) data, available for 80 patients, revealed that the mean total healthcare cost over the five years preceding diagnosis was 3.0 times higher (95% CI 2.3, 3.9) than that of the control cohort (p < 0.001). Most of these excess costs were attributed to secondary care visits and procedures. Although the RCC- or UCC-associated costs decreased post-diagnosis, they remained higher than those of the control cohort.

In conclusion, diagnosing RCC or UCC imposes a significant burden on healthcare resources, with substantial costs incurred in the five years leading up to a specialist clinic diagnosis. While resource utilization lessened after diagnosis, it exceeded that of a matched control cohort. These findings underscore the need for improved management strategies for RCC and UCC to alleviate the long-term healthcare burden and associated costs.

Source: respiratory-research.biomedcentral.com/articles/10.1186/s12931-024-02881-4