Burden of chronic cough in the UK: results from the 2018 National Health and Wellness Survey

Abstract

Background: Chronic cough, defined as daily cough for at least 8 weeks, negatively affects quality of life and work productivity and increases healthcare resource utilisation. We aimed to determine the prevalence and burden of chronic cough in the UK.

Methods: Study participants were general population respondents to the 2018 UK National Health and Wellness Survey (NHWS). Respondents completed survey questions relating to health, quality of life, work productivity and activity impairment, and use of healthcare resources. Prevalence estimates were projected to the UK population using post-stratification sampling weights to adjust for sampling bias. The population with chronic cough was matched 1:3 with a group without chronic cough, using propensity score matchingon age, sex and the modified Charlson Comorbidity Index.

Results: Of 15 000 NHWS respondents, 715 reported chronic cough in the previous 12 months and 918 during their lifetime. Weighted to the UK adult population, the 12-month prevalence of chronic cough was 4.9% and lifetime prevalence was 6.2%. Prevalence of chronic cough was higher among older respondents and those with smoking histories. Chronic cough respondents experienced higher rates of severe anxiety and depression in the past 2 weeks than matched controls. Poor sleep quality and loss of work productivity were also observed. More chronic cough respondents visited a healthcare provider in the past 6 months than respondents without chronic cough with a mean of 5.8 and 3.7 visits per respondent, respectively.

Conclusion: Adults with chronic cough report lower quality of life, reduced work productivity and greater healthcare resource utilisation than matched controls without chronic cough.

FIGURE 1

Depression severity (Patient Health Questionnaire 9-item (PHQ-9) scale) by chronic cough status. Respondents with chronic cough in the last 12 months were matched 1:3 for age, sex and Charlson Comorbidity Index (modified to exclude COPD) with respondents without chronic cough in the last 12 months. Depression symptoms over the prior 2 weeks were assessed on a scale of 0–27 using the PHQ-9 module [27]. n=715 (chronic cough); n=2145 (no chronic cough).

FIGURE 2

Work productivity loss by chronic cough status. Respondents with chronic cough in the last 12 months were matched 1:3 for age, sex and Charlson Comorbidity Index (modified to exclude COPD) with respondents without chronic cough in the last 12 months. Employed respondents (including full-time, part-time and self-employment) were asked to provide information about their absenteeism (percentage of work time missed because of one's health in the past 7 days), presenteeism (percentage of impairment experienced while at work in the past 7 days because of one's health) and total work productivity loss (an overall impairment estimate that is a combination of absenteeism and presenteeism). n=307 (chronic cough); n=996 (no chronic cough).

FIGURE 3

Healthcare resource use by chronic cough status. Respondents with chronic cough in the last 12 months were matched 1:3 for age, sex and Charlson Comorbidity Index (modified to exclude COPD) with respondents without chronic cough in the last 12 months. All respondents provided yes/no answers to questions about healthcare resource use over the prior 6 months. n=715 (chronic cough); n=2145 (no chronic cough).