Clinical impact and Healthcare Resource Utilization in Patients with Unexplained or Refractory Chronic Cough: A French National Population Study

Background The epidemiological, clinical and medico-economic burden of unexplained or refractory chronic cough (URCC) is poorly known. Objective To describe socio-demographic characteristics, clinical impact, healthcare resource utilization (HCRU) and associated costs in French URCC patients. Methods Populations of interest (CC, URCC, controls) were identified from the general population-based CONSTANCES cohort (124 565 participants at the time of study inception) and invited to answer a specific ad-hoc questionnaire on cough. Their HCRU data were extracted from the National Healthcare Database System. Results Populations of interest were identified among participants for whom data and questionnaire responses were available (n=5277): URCC (n=116), non-URCC (n=1357) and no CC (reference group; n=3804). The extrapolated frequency of CC and URCC in the CONSTANCES cohort were 3.8% and 0.22%, respectively. URCC was mainly associated with gastroesophageal reflux disease (31.0%) and asthma/chronic obstructive pulmonary disease (18.3%). Depressive symptoms (CES-D score ≥16) were significantly more frequent in patients with URCC compared to controls (43.0% versus 24.0%, respectively; p=0.0036). Over the past 12 months, the mean number of medical visits was higher in URCC group than in controls (9.1 versus 6.0; p=0.0002). Treatment for underlying conditions of interest were also more frequent in URCC group. Compared to controls, a 36% increase in medical visits and a four-times increase in treatments of underlying conditions of interest was observed in URCC group. Conclusion This study highlighted that URCC is associated with an important clinical impact and high HCRU and associated costs. The burden of URCC is significant and remains an unmet medical need.