Real-world survey on utilization of central antitussives and its health impact in patients with subacute and chronic cough in Japan

Despite guideline recommendations against the long-term use of central antitussives, actual clinical practice remains unclear. We aimed to investigate prescription patterns of central antitussives in patients with cough using Japanese claims data. In this retrospective cohort study, we evaluated patients aged ≥ 20 years with subacute and chronic cough from IQVIA Claims database. The primary outcome was the number of days central antitussives were prescribed. Additionally, we examined co-occurrence patterns of comorbidities and adverse events, specifically nausea and constipation, in relation to the duration of central antitussive prescription. Among 10,385 patients with subacute/chronic cough, 4431 (42.7%) were prescribed central antitussives. A longer duration of central antitussives prescription was significantly associated with a higher frequency of comorbidities. Specifically, the proportion of bronchial asthma/cough variant asthma, allergic rhinitis/chronic rhinosinusitis, and gastroesophageal reflux disease increased with the number of prescribed days of central antitussive. Adjusted odds ratio (95%CI) for constipation and nausea were 1.80 (1.18-2.76) and 2.06 (1.15-3.70), respectively, in patients prescribed central antitussives for > 57 days compared to those prescribed for 0-28 days. Appropriate treatment of comorbidities and prescription of central antitussives are warranted.