Patient profile and prevailing trends of cough management in India: Results of the COFPRO Survey

Abstract

Objective: To find the profile and management pattern of cough in out patients visiting family physicians (general practitioners) in India. Material and methods: The survey was done in two phases (monsoon and winter). Parameters captured included occupational exposure of infection or irritant, duration of cough, history of similar episodes, nature, intensity and frequency of cough, associated symptoms, co-morbid conditions, concomitant medications, self-medication and drugs used for treatment of cough. Result: Of the 5115 enrolled patients (male 69%; female 31%),2404 (47%)had exposure to infection or irritants at work place. Duration of cough was five days in 3069 (60%) patients while 5064 (99%) had similar episodes in last 12 months. Nature of cough in 2916 (57%) patients was dry with no or minimal sputum. A total of 1995 (39%) patients had two to six bouts of cough per day whereas six to ten cough bouts were reported by 1739 (34%) patients. Common associated symptoms were headache 1330 (26%), hoarseness of voice 1228(24%), sore throat/throat pain 1125 (22%), nasal stuffiness 972 (19%), runny nose 921(18%), sleep disturbances 818(16%), sneezing 665 (13%), fatigue/body ache 614 (12%) and fever 614 (12%). Allergic rhinitis and asthma was present in 2506 (49%) and 512 (10%) patients respectively. History of self-medication was present in only 614 (12%) patients which included OTC/herbal cough syrups. Adverse events related to self medication included sleep pattern disturbances (excess and reduced) reported by 51% patients. Antitussives, decongestants, antibiotics and antihistamines were prescribed in 4245 (83%), 4552 (89%), 2609 (51%) and 2456 (48%) patients respectively. Conclusion: Patients with recurrent cough may have exposure to infection or irritants at the place of job. Dry cough with up to 10 bouts per day and atleast one similar episode history is the most common type of cough presenting to family physicians (general practitioners). Majority of patients seek medical opinion within five days of starting of cough symptom and self medication rate was low. Allergic rhinitis is the most common (49%) comorbid condition with cough. Antitussives, decongestants, antibiotics and antihistamines are the common medicines used for management of cough.