Researchers found that adults with chronic cough reported lower quality of life, greater health care resource utilization, and reduced work productivity than those without it.
Because past studies had not accurately defined chronic cough within UK adults, the researchers aimed to “describe the prevalence of self-reported chronic cough” in this population. Their study also compared patients’ demographics, health characteristics, health care resource use (HCRU), quality of life (QOL), sleep difficulties, and work and activity impairment to that of matched controls without chronic cough.
The study population consisted of UK National Health and Wellness Survey (NHWS) respondents between April and July 2018. Those eligible for the study also had to be 18 years or older and able to read and write English; the researchers wanted to create a study population representative of the UK adult population.
The researchers determined that respondents who answered “yes” to the question, “Have you ever experienced chronic cough (daily, for 8 weeks or longer)?” had lifetime chronic coughs. Similarly, researchers identified those who answered “yes” to the question, “Have you ever experienced chronic cough (daily, for 8 weeks or longer) within the past 12 months?” as having had chronic cough within the previous 12 months.
To examine their secondary objectives, the researchers utilized a variety of surveys and questionnaires. The researchers measured health-related QOL using the Medical Outcomes Study 12-item Short Form Survey Version 2 (SF-12v2), the 6-dimensional health state short form (SF-6D), and the EuroQol 5-Dimension Health Questionnaire (EQ-5D). Also, they used the General Anxiety Disorder 7-item scale to assess self-reported anxiety and the Patient Health Questionnaire 9-item scale to assess self-reported depression.
Additionally, the researchers explained that they asked NHWS respondents about sleep difficulties. They also measured the patients’ work and activity productivity through the Work Productivity and Activity Impairment Questionnaire. Lastly, the study population gave insight into their HCRU by reporting their number of visits to health care providers within the past 6 months.
Of the 15,000 adults eligible, 918 (6.1%) reported having had a chronic cough at some point in their lifetime and 715 (4.8%) reported experiencing it in the past 12 months. The weighted prevalence estimates showed that 6.2% of the UK population experienced lifetime chronic cough and 4.9% experienced it in the past 12 months.
The researchers found that chronic cough was more prevalent in women and respondents older than 50 years. Additionally, patients with chronic cough were significantly more likely to have a smoking history (58.9% vs 48.0%), not exercise (49.8% vs 42.5%), be obese (27.8% vs 22.9%), and have higher rates of anxiety (57.1% vs 33.4%) and depression (65.7% vs 40.2%) in the past 2 weeks (P < .001 for all comparisons).
Respondents with chronic cough scored lower on questionnaires measuring health-related QOL, indicating worse mental and physical health, therefore worse QOL. Additionally, the researchers explained that employed respondents with chronic cough experienced higher rates of work productivity impairment as they experienced 16% greater daily activity impairment, more than twice the level of absenteeism, and a 15% higher rate of presenteeism than those without chronic cough (P < .001 for all).
In addition, the researchers noted that people with chronic cough had more sleep disturbances than those without. For example, between 33% and 45% of respondents with chronic cough reported regularly having trouble falling asleep and having a poor quality of sleep whereas between one-fourth and one-third of those without chronic cough reported the same (P < .001 for each comparison). In terms of HCRU, more respondents with chronic cough visited a health care provider in the past 6 months (P < .001), with a mean of 5.8 and 3.7 visits per person with and without chronic cough, respectively (P < .001).
Overall, the researchers found that UK adults with chronic cough reported “lower quality of life, reduced work productivity and greater healthcare resource utilization than matched controls without chronic cough.” On the other hand, they acknowledged several limitations to their study, one being that it involved many self-reported measures from the past year without physician confirmation or testing; this could have introduced recall and self-presentation biases.
Despite its limitations, the researchers felt their study gave helpful insight into the prevalence of chronic cough within the United Kingdom.
“Our findings provide a detailed characterization of the prevalence and burden of chronic cough in the UK that will inform future efforts to raise awareness, promote management strategies, develop effective treatments, and consider the educational and support needs of patients with chronic cough,” the authors concluded.
McGarvey L, Morice AH, Martin A, et al. Burden of chronic cough in the UK: results from the 2018 National Health and Wellness Survey. ERJ Open Res. 2023;9(4):00157-2023. doi:10.1183/23120541.00157-2023