# Characteristics of US Medicare Beneficiaries with Chronic Cough vs. Non-Chronic Cough: 2011–2018

## TL;DR

This study compares characteristics and gabapentinoid use trends in Medicare beneficiaries with and without chronic cough from 2011 to 2018.

## Contribution

The study identifies distinct gabapentinoid utilization patterns and higher comorbidity burdens in patients with chronic cough.

## Key findings

- Gabapentinoid use increased in both chronic cough and non-chronic cough groups from 2011 to 2018.
- Chronic cough patients had higher comorbidity burdens and medication use compared to non-chronic cough patients.
- GBTM identified three gabapentinoid utilization trajectories: no use, low use, and high use.

## Abstract

Background: Chronic cough (CC), characterized as a cough lasting >8 weeks, is a common multi-factorial syndrome in the community, especially in older adults. Methods: Using a pre-existing algorithm to identify patients with CC within the 2011–2018 Medicare beneficiaries, we examined trends in gabapentinoid use through repeated cross-sectional analyses and identified distinct utilization trajectories using group-based trajectory modeling (GBTM) in a retrospective cohort study. Individuals without CC but with any respiratory conditions related to cough served as a comparator group. Results: Among patients with CC, gabapentinoid use increased from 18.6% in 2011 to 24.1% in 2018 (p = 0.002), with a similar upward trend observed in the non-CC cohort but with overall lower usage (14.7% to 18.4%; p < 0.001). Patients with CC had significantly higher burdens of respiratory and non-respiratory comorbidities, as well as greater healthcare service and medication use compared to the non-CC cohort. The GBTM analyses identified three distinct gabapentinoid utilization trajectories for CC and non-CC patients: no use (77.3% vs. 84.5%), low use (13.9% vs. 10.3%), and high use (8.8% vs. 5.2%). Conclusions: Future studies are needed to evaluate the safety and effectiveness of gabapentinoid use in patients with refractory or unexplained CC in real-world settings.