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. 2020 Jan;7(1):49-59.
doi: 10.15326/jcopdf.7.1.2019.0146.

The Burden of Cough and Phlegm in People With COPD: A COPD Patient-Powered Research Network Study

Radmila Choate  1   2 , Cara B Pasquale  1 , Nereida A Parada  3 , Valentin Prieto-Centurion  4 , Richard A Mularski  5 , Barbara P Yawn  1
Affiliations

The Burden of Cough and Phlegm in People With COPD: A COPD Patient-Powered Research Network Study

Radmila Choate et al. Chronic Obstr Pulm Dis. 2020 Jan.

Abstract

Rationale: Cough and phlegm are common symptoms of chronic obstructive pulmonary disease (COPD) and may significantly affect quality of life. This study assessed the burden of cough and phlegm on clinical outcomes and quality of life among people with a self-reported physician diagnosis of COPD.

Methods: Patient-reported data from the COPD Foundation's Patient-Powered Research Network (COPD PPRN) were utilized. Cough and phlegm severity and frequency were assessed by responses to questions on the COPD Assessment Test (CAT) and categorized into none/low, moderate and severe. Quality of life domains were evaluated using the Patient-Reported Outcome Measurement Information System (PROMIS-29). Associations between cough and phlegm levels and PROMIS-29 domains were examined using multivariate analysis of variance (MANOVA).

Results: The 5286 participants were average age 64.4 years (SD=11.4), 87.9% white, 60.4% female, 51.2% married, and 42.2% with caregivers. Approximately three-fourths of the participants had moderate or severe cough or phlegm levels. Respondents with moderate and high cough or phlegm had significantly worse dyspnea (p<0.0001), more exacerbations in the previous one year (p<0.0001), worse physical and social functioning, and more symptoms of anxiety and depression on PROMIS-29 compared to those with no/low cough and phlegm.

Conclusions: In this group of people with COPD, higher levels of cough and phlegm are associated with worse clinical and quality of life outcomes.

Keywords: COPD exacerbation; COPD treatment ratio; CTR; chronic obstructive pulmonary disease; copd; maintenance medication; rescue inhaler.

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Conflict of interest statement

RC, RAM, and CBP report no conflict. NAP reports serving as a clinical advisor to Respirtech, a Phillips Company not related to the present work. VPC reports research funding by ResMed not related to the present work. BPY reports serving on advisory boards for GlaxoSmithKline, AstraZeneca, Novartis and Boehringer Ingelheim related to COPD.

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