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Abstract：
OBJECTIVE: To show clinical characteristics, treatments, and comorbidities in chronic cough in a nationwide cohort.
METHODS: Two cohorts were created. A national cohort with individuals from two population-based databases; the National Patient Register and Swedish Prescribed Drug Register. Secondly, a regional cohort including primary care data. Adults with at least one cough diagnosis (ICD-10 R05) and/or individuals with ≥2 dispensed prescriptions for relevant cough-medication within the inclusion period, 2016-2018, were identified. Individuals on medications which may instigate cough or suggest acute infection or diagnosed with conditions where cough is a cardinal symptom, were excluded. Those remaining were defined as having possible refractory or unexplained chronic cough (RCC/UCC).
RESULTS: Altogether 62,963 individuals were identified with possible RCC/UCC, giving a national prevalence of about 1%. Mean age was 56 years and 60% were females. Many (44%) of the individuals with possible RCC/UCC visited cough relevant specialist clinics during the study period, but less than 20% received a cough diagnosis. A majority (63%) had evidence of RCC/UCC in the 10 years prior to inclusion in the study. In the regional cohort, including primary care data, the prevalence of RCC/UCC was doubled (2%). Cough medicines were mainly prescribed by primary care physicians (82%).
CONCLUSIONS: Most individuals with possible RCC/UCC sought medical care in primary care, and had a long history of cough, with various treatments tried, indicating a substantial burden of the condition. Referrals to specialist care were very rare. The results underline the need for a structured multidisciplinary approach and future therapeutic options.
METHODS: Two cohorts were created. A national cohort with individuals from two population-based databases; the National Patient Register and Swedish Prescribed Drug Register. Secondly, a regional cohort including primary care data. Adults with at least one cough diagnosis (ICD-10 R05) and/or individuals with ≥2 dispensed prescriptions for relevant cough-medication within the inclusion period, 2016-2018, were identified. Individuals on medications which may instigate cough or suggest acute infection or diagnosed with conditions where cough is a cardinal symptom, were excluded. Those remaining were defined as having possible refractory or unexplained chronic cough (RCC/UCC).
RESULTS: Altogether 62,963 individuals were identified with possible RCC/UCC, giving a national prevalence of about 1%. Mean age was 56 years and 60% were females. Many (44%) of the individuals with possible RCC/UCC visited cough relevant specialist clinics during the study period, but less than 20% received a cough diagnosis. A majority (63%) had evidence of RCC/UCC in the 10 years prior to inclusion in the study. In the regional cohort, including primary care data, the prevalence of RCC/UCC was doubled (2%). Cough medicines were mainly prescribed by primary care physicians (82%).
CONCLUSIONS: Most individuals with possible RCC/UCC sought medical care in primary care, and had a long history of cough, with various treatments tried, indicating a substantial burden of the condition. Referrals to specialist care were very rare. The results underline the need for a structured multidisciplinary approach and future therapeutic options.
摘要：
目的：显示临床特征，治疗,全国队列中慢性咳嗽的合并症。
方法：创建两个队列。来自两个基于人群的数据库的国家队列；国家患者登记册和瑞典处方药物登记册。其次,包括初级保健数据的区域队列。在纳入期内，至少有一次咳嗽诊断（ICD-10R05）的成年人和/或有≥2次相关咳嗽药物处方的人，2016-2018年，已确定。服用可能引起咳嗽或提示急性感染或诊断为咳嗽为主要症状的疾病的个人，被排除在外。其余的被定义为可能患有难治性或无法解释的慢性咳嗽（RCC/UCC）。
结果：总共有62,963名个体被确定为可能的RCC/UCC，全国患病率约为1%。平均年龄为56岁，60%为女性。在研究期间，许多（44％）可能患有RCC/UCC的人访问了咳嗽相关的专科诊所，但不到20%的人被诊断为咳嗽.大多数（63％）在纳入研究之前的10年内有RCC/UCC的证据。在区域队列中，包括初级保健数据，RCC/UCC的患病率增加了一倍(2%).咳嗽药物主要由初级保健医生开(82%)。
结论：大多数可能患有RCC/UCC的人在初级保健中寻求医疗护理，有很长的咳嗽史,尝试了各种治疗方法，表明该状况的沉重负担。转介专科护理非常罕见。结果强调需要结构化的多学科方法和未来的治疗选择。
方法：创建两个队列。来自两个基于人群的数据库的国家队列；国家患者登记册和瑞典处方药物登记册。其次,包括初级保健数据的区域队列。在纳入期内，至少有一次咳嗽诊断（ICD-10R05）的成年人和/或有≥2次相关咳嗽药物处方的人，2016-2018年，已确定。服用可能引起咳嗽或提示急性感染或诊断为咳嗽为主要症状的疾病的个人，被排除在外。其余的被定义为可能患有难治性或无法解释的慢性咳嗽（RCC/UCC）。
结果：总共有62,963名个体被确定为可能的RCC/UCC，全国患病率约为1%。平均年龄为56岁，60%为女性。在研究期间，许多（44％）可能患有RCC/UCC的人访问了咳嗽相关的专科诊所，但不到20%的人被诊断为咳嗽.大多数（63％）在纳入研究之前的10年内有RCC/UCC的证据。在区域队列中，包括初级保健数据，RCC/UCC的患病率增加了一倍(2%).咳嗽药物主要由初级保健医生开(82%)。
结论：大多数可能患有RCC/UCC的人在初级保健中寻求医疗护理，有很长的咳嗽史,尝试了各种治疗方法，表明该状况的沉重负担。转介专科护理非常罕见。结果强调需要结构化的多学科方法和未来的治疗选择。
