Efficacy perception and prescription of treatments for refractory/unexplained chronic cough by Spanish physicians

Background: Evidence on treatment patterns for patients with refractory/unexplained chronic cough (RCC/UCC) is limited. Aims/objective: To assess the perception of Spanish physicians regarding frequency of prescription and efficacy of drugs for RCC/UCC patients and the correlation prescription/efficacy perception. Methods: Anonymous web-based survey completed by 620 primary care physicians (PCP), 92 pulmonologists and 62 allergists. They scored their frequency of prescription of drugs for RCC/UCC patients and perception of efficacy from 1 (low) to 10 (high). A correlation study prescription/efficacy perception was performed with the Spearman’s Rho coefficient. Results: Drugs with the highest prescription score (median 6-8) were inhaled bronchodilators and steroids, antihistamines and, for PCP, cough suppressants. Only inhaled bronchodilators and steroids, oral steroids and, for PCPs and pulmonologists, opioids, reached a median efficacy score >5 (median 6-7). Neuromodulators, mucolytics (except for PCP, score 5), levodropropizine and terpenic derivates showed median scores of efficacy and prescription of 3 or below. Square correlation coefficients (ρ2) for each therapy/specialist varied between 0.22 and 0.57, suggesting that between 22% and 57% of prescription is associated with the efficacy perception. Conclusion: For RCC/UCC, physicians regard inhaled bronchodilators and steroids and antihistamines as the most prescribed therapies. Most of the treatments are perceived as of low efficacy, and efficacy perception only explains a part of the prescription. Acknowledgments: Funded by MSD Spain. We thank SEAIC, SEPAR, SEMFYC, SEMG, SEMERGEN for helping with survey execution