[Investigation on status of lung cancer cough management and concept and practice of lung cancer cough management in Chinese medical providers]

Zhonghua Yi Xue Za Zhi. 2021 Jun 8;101(21):1583-1591. doi: 10.3760/cma.j.cn112137-20210413-00877.
[Article in Chinese]

Abstract

Objective: Investigate the current situation of lung cancer cough diagnosis and treatment and the awareness of related issues among Chinese medical providers. Methods: Doctors, nurses, pharmacists from the oncology department, respiratory department, or general department were investigated using an electronic questionnaire from January 29 to March 29, 2021. There were 25 questions about lung cancer in the questionnaire. The questionnaire was including the most common accompanying symptoms in patients with lung cancer, the incidence of lung cancer-related cough, the assessment of the proportion of central antitussive drugs, and the commonly used central antitussives. Results: Questionnaires from 2 424 medical providers were collected from 402 hospitals in 21 provincial administrative units. Cough was the most common symptom in lung cancer. Most physicians believed that the incidence of lung cancer-related cough was 51%~75%, while the proportion of patients satisfied with the treatment was only 11%~20%. The evaluation of lung cancer-related cough was seriously insufficient. The leading cause of lung cancer-related cough was tumors. And the main problem was the inadequate antitussive effect of drugs in lung cancer-related cough management. The proportion of central antitussive medication usage in the secondary and tertiary hospitals was 93.9% and 92.0%, significantly higher than 75.0% in Primary hospitals (χ²=8.390, P=0.015). The proportion of the physicians who underhanded that codeine is at risk of addiction was 76.6% and 72.0% in the secondary and tertiary hospitals, which were significantly higher than 53.9% in Primary hospitals (χ²=9.240, P=0.010). In different occupations, the proportions of doctors and pharmacists who knew the risk of addicting to codeine were 73.0% and 82.6%, which were significantly higher than the 66.4% of nurses (χ²=21.200, P<0.001). The Chinese medical providers were lack of training about the basic knowledge of using central antitussive medication. Conclusions: The proportion of patients who were satisfied with the effect of cough treatment is low. The medical staff did not have enough awareness of this. There was an urgent need to develop a consensus and standardize lung cancer cough diagnosis and treatment in China.

目的: 了解我国肺癌相关性咳嗽诊疗现状及医务人员对相关问题的认知情况。 方法: 2021年1月29日至3月29日,以电子问卷形式,对全国肿瘤科、呼吸科、全科等肺癌相关咳嗽诊疗科室的医师、护士和药师进行调研。除基本信息外,收集共计25个肺癌相关问题,包括肺癌患者最常见伴随症状、肺癌相关性咳嗽发生率及评估、中枢镇咳用药比例、常用中枢镇咳药等。 结果: 收集到全国21个省级行政单位、402家医院、2 424名医护人员的调查问卷。咳嗽是肺癌患者最常见的伴随症状,多数医师认为肺癌相关性咳嗽发生率为51%~75%,而对咳嗽治疗效果表示满意的患者比例仅为11%~20%。肺癌相关性咳嗽的评估严重不足,肿瘤相关因素是引起肺癌相关性咳嗽的主要原因。药物镇咳作用不够理想是目前肺癌相关性咳嗽管理的最主要问题。二、三级医院使用中枢镇咳药物比例分别为93.9%和92.0%,显著高于一级医院的75.0%,差异有统计学意义(χ²=8.390,P=0.015)。二、三级医院了解可待因存在成瘾风险的人员比例分别为76.6%、72.0%,显著高于一级医院的53.9%,差异有统计学意义(χ²=9.240,P=0.010)。不同职业中,了解可待因存在成瘾风险的医师和药师比例分别为73.0%、82.6%,显著高于护士的66.4%,差异有统计学意义(χ²=21.200,P<0.001)。关于中枢镇咳药物基本认知方面,医务工作者培训严重不足。 结论: 对咳嗽治疗效果表示满意的患者比例较低,医务人员对此认知不足,应尽快形成我国的肺癌相关性咳嗽诊疗共识和规范。.

MeSH terms

  • Antitussive Agents* / therapeutic use
  • China / epidemiology
  • Cough / drug therapy
  • Cough / etiology
  • Humans
  • Lung Neoplasms* / complications
  • Surveys and Questionnaires

Substances

  • Antitussive Agents