Medication and healthcare use, parent knowledge and cough in children: A cohort study

Joan Cheng, Amelia Mackie, Anne B. Chang, Keith Grimwood, Mark Scott, Alex King, Vikas Goyal, Julie M. Marchant, Kerry Ann F. O'Grady

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)

Abstract

Introduction: Cough is an important contributor to the health burden of children and their families. There are limited data describing healthcare utilization and medication use over the course of a cough illness beyond the initial presentation. Our primary objective was to describe medication and healthcare use in children with a respiratory illness with cough as a symptom over the course of the illness. 

Methods: A cohort study of children aged less than 15-years presenting to three primary healthcare centers and three emergency departments with a cough illness between July 7, 2015 and October 6, 2018. Children with immunosuppression, known chronic lung diseases (except asthma) and those requiring hospitalization at screening were excluded. The primary outcomes were cough-related frequency and type of healthcare seeking and medication use up to 28 days following enrolment. 

Results: Data for 465 children were analyzed; median age 2.2-years (interquartile range = 1.1–5.3). Cough at Day 28 persisted in 117 children (25.2%). Overall, 436 (94%) children received medications in the week before and/or 4 weeks following enrolment. Half with upper respiratory tract infections were prescribed antibiotics. Among children with no diagnosis of asthma, reactive airways disease or croup (n = 404), 16.8% were given steroids. Fifty-eight percent of children sought healthcare at least once before their baseline presentation (median = 1, range = 0–20) and 49.7% had at least one further presentation in the following 28 days. 

Conclusions: High healthcare utilization, inappropriate medication use, and suboptimal parent knowledge regarding cough suggests targeted education is needed to improve management and reduce cough burden.

Original languageEnglish
Pages (from-to)2345-2354
Number of pages10
JournalPediatric Pulmonology
Volume56
Issue number7
DOIs
Publication statusPublished - Jul 2021

Bibliographical note

Funding Information:
We thank the staff of the Caboolture, Toowoomba and Queensland Children's Hospital emergency departments and of the Carbal Medical Services and Caboolture Community Medical for their support of this study. Particular thanks to Somerville House School and Erica McLean (Head of Science) for their support of the STEM Internship program for AM and JC at the Center for Children's Health Research. Finally, to Sheree Rablin, Jack Roberts, Daniel Arnold, Judith Zenchyson, Renee Johnstone, Sarah Parfitt, Yolanda Lovie‐Toon, Michelle Kaus, and Kerry Hall for their commitment to the study. This study was supported by a National Health and Medical Research Council (NHMRC) Project Grant (APP1080298) and by the NHMRC Centre for Research Excellence in Clinical Research (Closing the Gap in Indigenous Lung Health, APP1040830). KFO was supported by a NHMRC Career Development Fellowship (APP1045157) and ABC is supported by a NHMRC Practitioner Fellowship (APP1058213).

Funding Information:
We thank the staff of the Caboolture, Toowoomba and Queensland Children's Hospital emergency departments and of the Carbal Medical Services and Caboolture Community Medical for their support of this study. Particular thanks to Somerville House School and Erica McLean (Head of Science) for their support of the STEM Internship program for AM and JC at the Center for Children's Health Research. Finally, to Sheree Rablin, Jack Roberts, Daniel Arnold, Judith Zenchyson, Renee Johnstone, Sarah Parfitt, Yolanda Lovie-Toon, Michelle Kaus, and Kerry Hall for their commitment to the study.?This study was supported by a National Health and Medical Research Council (NHMRC) Project Grant (APP1080298) and by the NHMRC Centre for Research Excellence in Clinical Research (Closing the Gap in Indigenous Lung Health, APP1040830). KFO was supported by a NHMRC Career Development Fellowship (APP1045157) and ABC is supported by a NHMRC Practitioner Fellowship (APP1058213).

Publisher Copyright:
© 2021 Wiley Periodicals LLC

Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.

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