PDF(Pubmed)
Abstract：
Background: Chronic cough (CC), characterized as a cough lasting >8 weeks, is a common multi-factorial syndrome in the community, especially in older adults. Methods: Using a pre-existing algorithm to identify patients with CC within the 2011-2018 Medicare beneficiaries, we examined trends in gabapentinoid use through repeated cross-sectional analyses and identified distinct utilization trajectories using group-based trajectory modeling (GBTM) in a retrospective cohort study. Individuals without CC but with any respiratory conditions related to cough served as a comparator group. Results: Among patients with CC, gabapentinoid use increased from 18.6% in 2011 to 24.1% in 2018 (p = 0.002), with a similar upward trend observed in the non-CC cohort but with overall lower usage (14.7% to 18.4%; p < 0.001). Patients with CC had significantly higher burdens of respiratory and non-respiratory comorbidities, as well as greater healthcare service and medication use compared to the non-CC cohort. The GBTM analyses identified three distinct gabapentinoid utilization trajectories for CC and non-CC patients: no use (77.3% vs. 84.5%), low use (13.9% vs. 10.3%), and high use (8.8% vs. 5.2%). Conclusions: Future studies are needed to evaluate the safety and effectiveness of gabapentinoid use in patients with refractory or unexplained CC in real-world settings.
摘要：
背景：慢性咳嗽（CC），咳嗽持续>8周，是社区中常见的多因素综合征，尤其是老年人。方法：使用预先存在的算法来识别2011-2018年医疗保险受益人中的CC患者，在一项回顾性队列研究中,我们通过重复的横断面分析研究了加巴喷丁类药物的使用趋势,并使用基于群组的轨迹模型(GBTM)确定了不同的使用轨迹.没有CC但具有与咳嗽相关的任何呼吸状况的个体作为比较组。结果：在CC患者中，gabapentinoid的使用量从2011年的18.6%增加到2018年的24.1%(p=0.002)，在非CC队列中观察到类似的上升趋势，但总体使用率较低（14.7％至18.4％；p<0.001）。CC患者的呼吸道和非呼吸道合并症负担明显较高，以及与非CC队列相比，更多的医疗服务和药物使用。GBTM分析确定了CC和非CC患者的三种不同的gabapentinoid利用轨迹：无使用（77.3％vs.84.5%)，低使用率(13.9%与10.3%），和高使用率(8.8%与5.2%）。结论：未来的研究需要评估在真实世界中难治性或原因不明的CC患者中使用加巴喷丁的安全性和有效性。
