Mismatched Expectations on Average Duration of Cough

Patients dramatically underestimate the mean duration of acute cough illness

TUESDAY, Jan. 15 (HealthDay News) -- Patients tend to underestimate the average duration of acute cough illness (ACI), according to research published in the January/February issue of the Annals of Family Medicine.

Mark H. Ebell, M.D., of the University of Georgia in Athens, and colleagues conducted a population-based random digit dialing survey involving 493 adults in Georgia to assess their expectations regarding cough duration. In addition, they performed a systematic review of the literature to assess the duration of ACI, based on the placebo or untreated control groups from randomized controlled trials.

According to the medical literature, the researchers found that the mean duration of ACI was 17.8 days. However, surveyed adults reported a mean duration of 7.2 to 9.3 days, depending on the specific scenario. The expectation of a longer duration of cough was more likely among patients who were white, female, and had asthma or chronic lung disease. Those most likely to believe that antibiotics are always helpful tended to be nonwhite (odds ratio [OR], 1.82), have some college education or less (OR, 2.08), and to have previously received antibiotics for ACI (OR, 2.20).

"We found a large mismatch between patients' expectations regarding the duration of acute cough illness and its actual natural history based on a systematic review of the best available published evidence," the authors write. "We believe that education of the general public, the media, and physicians should emphasize appropriate expectations regarding the natural history of ACI in order to reduce inappropriate demands for antibiotics."

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