Approach of Primary Physicians in the Management of Chronic Cough, in Najran City, Saudi Arabia

Background: Chronic cough can impair quality of life, with serious biomedical and psychosocial impacts. This condition should be managed well by physicians at primary health care level. Objective: To evaluate the approach of primary physicians in the management of chronic cough. Materials and Methods: Cross-sectional study was conducted using an interviewer-administered questionnaire from September 2018-March 2019 in Najran City, Saudi Arabia. All primary physicians (n = 134) working at different primary health care facilities during the study period who agreed to participate were included. Results: The prevalence of chronic cough at primary physician's practice was 25%. The study revealed around 61 % of primary physicians (n=134) have good clinical experience of the management of chronic cough despite the widespread of clinical guidelines. They make definitive diagnosis of chronic cough as following; 66% based on history &physical examination,61% based on further tests and 60 % based on response to empiric therapy. They diagnose their cases secondary to allergy (63%), inflammation (60%), infection (59%), medications (42%) and malignancy (33%). The study showed inadequacy of participants in treating the chronic cough; 63% prescribe a decongestant & an antihistamine for upper airway cough syndrome (UACS), 81% prescribe an inhaled bronchodilators or corticosteroids for asthma, 79% prescribe an antacid agent for gastro-esophageal reflux disease (GERD) and 60% refer to specialized clinic. About 46% of participants approach the child with chronic cough as same as adult approach. Conclusion: Chronic cough is high prevalent in practice of primary care physicians. Although the widespread dissemination of management guidelines of chronic cough, the inadequacy in clinical practice of primary physicians still occurs. Design educational programs and increased awareness for patients and their families about chronic cough are responsible solutions.