The demographics, clinical characteristics and quality of life of patients with chronic cough from the Isala Cough Clinic in the Netherlands

Abstract

Introduction: Chronic cough affects ∼10% of the population and adversely impacts quality of life. This retrospective observational cohort study aimed to identify the demographics, clinical characteristics and quality of life of the chronic cough population in a Dutch chronic cough clinic, at baseline and following treatment at 6 months. Patients were categorised based on the underlying phenotype and response to treatment.

Methods: Retrospective data on 2397 patients who were diagnosed according to standard guidelines of the American College of Chest Physicians were analysed. Quality of life was captured via the Leicester Cough Questionnaire, the Cough Numeric Rating Scale and the Hospital Anxiety and Depression Scale.

Results: Mean patient age was 59 years; 62.5% of the patients were female; and 69.1% had at least one underlying phenotype associated with chronic cough. Of the latter, 52.1% had bronchial hyperresponsiveness/airflow limitation, 33.3% had airway reflux and 20.1% had upper airway cough syndrome. 46% of patients with a phenotype, and 51% without, experienced no improvement in their quality of life or still had significant cough remaining after 6 months. Of patients with available quality-of-life data, 37.5% were categorised as having refractory chronic cough, and 9.5% were categorised as unexplained chronic cough.

Discussion: This study highlights the poor quality-of-life outcomes in patients with chronic cough, despite interventions to treat underlying conditions, and indicates a need to manage chronic cough irrespective of phenotype.

FIGURE 1

Correlation between patient improvement and Leicester Cough Questionnaire (LCQ) and the Cough Numeric Rating Scale (NRS-cough). a) Change (Δ) LCQ (n=806), mean±sd 2.6±2.9, median (range) 2.4 (0.6–0.4); b) Δ NRS-cough (n=1734), mean±sd −1.7±2.3, median (range) −2.0 (−4.0–0.0); c) the correlation of baseline LCQ with Δ LCQ; d) the correlation of baseline NRS-cough with Δ NRS-cough.

FIGURE 2

Flow chart showing the categorisation of patients as refractory chronic cough (RCC) or unexplained chronic cough (UCC). MCID: minimal clinically important difference; LCQ: Leicester Cough Questionnaire; NRS-cough: Cough Numeric Rating Scale.