Background: Chronic cough (CC) is a common reason for a physicians visit¹. For the separate entities of refractory chronic cough (RCC ? specific underlaying condition without resolution) or unexplained chronic cough (UCC ? without other disease) reliable real-life data are limited due to the absence of an ICD-10 code

Objectives: To evaluate characteristics of diagnosing and treatment of RCC/UCC patients (pts)

Methods: VICHAS: prospective observational study, conducted: 01.01.-31.12.2020 in 16 outpatient sites for respiratory care in Germany. Age, gender, diagnoses, medications, procedures, physiotherapy were documented

Results: Available information from 421 pts (71% women), 78% RCC, 22% UCC. Main underlying medical conditions: asthma 59%, GERD 19%. RCC disease duration: 5.8 years (y) vs 3.6y (<0.001) in UCC. Differences were found for: RCC vs UCC: Bronchial hypersensitivity test 40% vs 52% (p<0.05), cardiac examination 19% vs 7% (p<0.01). Symptomatic antitussives were prescribed significantly higher in UCC vs RCC: e.g. noscapine: 9% vs 3% (p<0.05), dextromethorphane 3% vs 1% (p<0.05), cough syrup 17% vs 7% (p<0.01). Treatments for RCC associated conditions were significantly higher in RCC, e.g. ICS/LABA 35% vs 9% (p<0.0001), inhaled anticholinergic 17% vs 1% (p<0.0001). No differences: other specialist consultation, procedures, other medications

Conclusion: Even though ERS guidelines (GL) in contrast to German GL do not differentiate between RCC and UCC, differences in disease duration and treatment were observed. This might be due to high awareness of chest physicians in cough management and/or the broader awareness of German cough guideline

1: Schappert, Vital Health Sta 2006:1-66