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Chen L, Lao KSJ, Yi F, Xia K, Lai K. Prevalence and disease burden of chronic cough in nine cities of China: an observational study. BMC Pulm Med 2024; 24:322. [PMID: 38965528 PMCID: PMC11225231 DOI: 10.1186/s12890-024-03017-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 04/15/2024] [Indexed: 07/06/2024] Open
Abstract
BACKGROUND Chronic cough (CC) is common in the general population of China, creating a difficult-to-ignore public health burden. However, there is a lack of research on the nationwide prevalence and disease burden of CC in the Chinese population. We aim to use an insurance claims database to assess the prevalence and the corresponding economic burden owing to CC in China. METHODS This was a retrospective observational study based on an administrative medical insurance database in 2015, 2016 and 2017, from nine cities in North, South, East, South-West, and North-West regions of China. The study population was Chinese adults (≥ 18 years old) who had been identified as CC patients. Descriptive data analyses were used in statistical analysis. RESULTS A total of 44,472, 55,565, and 56,439 patients with mean ages of 53.2 (16.3) years were identified as patients with CC in 2015, 2016, and 2017, respectively. Of these, 55.24% were women. In addition, 8.90%, 9.46%, and 8.37% of all patients in 2015, 2016, and 2017, who had applied for medical insurance, had CC, respectively, with a three-year average probability of 8.88%. The median number of outpatient visits within a calendar year was 27 per year due to any reason during the period of 2015-2017. The median medical cost of each patient per year increased from 935.30 USD to 1191.47 USD from 2015 to 2017. CONCLUSION CC is common among medical insurance users, with a substantial utilization of medical resources, highlighting the huge burden of CC in China.
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Affiliation(s)
- Lin Chen
- Global Medical Affairs, MRL, MSD China, Shanghai, China
| | - Kim S J Lao
- Global Medical and Scientific Affairs, MSD, Hong Kong, Hong Kong Special Administration Region, China
| | - Fang Yi
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Department of Pulmonary and Critical Care Medicine, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Kai Xia
- Global Medical Affairs, MRL, MSD China, Shanghai, China
| | - Kefang Lai
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, National Center for Respiratory Medicine, Department of Pulmonary and Critical Care Medicine, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
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2
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Bali V, Adriano A, Byrne A, Akers KG, Frederickson A, Schelfhout J. Chronic cough: more than just a persistent cough: a systematic literature review to understand the impact of chronic cough on quality of life. Qual Life Res 2024; 33:903-916. [PMID: 38153616 DOI: 10.1007/s11136-023-03556-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2023] [Indexed: 12/29/2023]
Abstract
PURPOSE Chronic cough (CC), defined as a cough persisting ≥ 8 weeks, can have a substantial negative impact on health-related quality of life (HRQoL). This is exacerbated by challenges with timely diagnosis and a lack of approved therapies. A systematic literature review (SLR) was conducted to identify evidence on HRQoL and health state utility values associated with refractory CC or unexplained CC. METHODS Electronic database searches were supplemented with searches of conference proceedings and health technology assessment body websites. Two independent reviewers assessed all citations for inclusion based on predefined inclusion/exclusion criteria. Key inclusion criteria were patient populations with CC and reporting of patient-reported outcomes or utilities using generic or disease-specific measures. RESULTS Following screening, 65 studies were identified for inclusion in the SLR. Of these, 23 studies assessed HRQoL among patients with CC who were not treated or treated with unspecified interventions, and 42 studies in patients who were treated with specified interventions. The studies indicated a substantial decrement to HRQoL as a result of CC, characterized by generic and disease-specific patient-reported outcome measures. HRQoL was impacted across multiple domains, including physical, psychological, and social functioning. The studies also demonstrated the potential for treatments to have a significant positive impact on HRQoL. CONCLUSIONS CC can substantially affect HRQoL in patients, across physical, psychological, and social domains. Although treatments can improve HRQoL in these patients, the available evidence is limited. There remains an unmet need for approved pharmacological treatments to alleviate CC and improve HRQoL for these patients.
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Affiliation(s)
- Vishal Bali
- Center for Observational and Real-World Evidence (CORE), Merck & Co. Inc, Rahway, NJ, USA.
- Merck & Co. Inc, 351 N Sumneytown Pike, Mailstop: UG4D-48, North Wales, PA, 19454, USA.
| | - Ada Adriano
- Outcomes Research, MSD (UK) Limited, London, UK
| | - Aidan Byrne
- Outcomes Research, MSD (UK) Limited, London, UK
| | | | | | - Jonathan Schelfhout
- Center for Observational and Real-World Evidence (CORE), Merck & Co. Inc, Rahway, NJ, USA
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3
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Byun JY, Chapman Lambert C, Fazeli PL, Iyer AS, Batey DS, Vance DE. Symptomatology and Quality of Life of Older People With HIV and Comorbid Chronic Obstructive Pulmonary Diseases From an HIV Clinic in Birmingham, Alabama. J Assoc Nurses AIDS Care 2024; 35:91-103. [PMID: 38319887 PMCID: PMC11216896 DOI: 10.1097/jnc.0000000000000452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
ABSTRACT Psychological symptomatology and quality of life (QoL) have been studied in older people with HIV (PWH) and those with chronic obstructive pulmonary disease (COPD), respectively, but there is a dearth of studies in older PWH with COPD. Our study compared depressive symptoms, anxiety, and QoL between older PWH with and without COPD using data from an HIV clinic in Birmingham, Alabama, from January 2018 to February 2020. Data on depressive symptoms (Patient Health Questionnaire-9), anxiety (Patient Health Questionnaire-5 Anxiety), and QoL (EuroQoL-5 Dimension) were analyzed. Among 690 PWH aged 50 years or older, 102 individuals (14.8%) had COPD. Significant differences were found between the two groups in depressive symptoms and components of QoL (e.g., mobility, self-care, usual activities, and pain/discomfort), but not in anxiety and general health. Experiencing COPD may worsen depressive symptomatology and QoL in older PWH, highlighting the need for tailored health care and research for this population.
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Affiliation(s)
- Jun Y Byun
- Jun Y. Byun, PhD, MSN, is a Postdoctoral Fellow, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Crystal Chapman Lambert, PhD, MSPH, CRNP, FNP-BC, ACRN, is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Pariya L. Fazeli, PhD, is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Anand S. Iyer, MD, MSPH, is an Assistant Professor in the Division of Pulmonary, Allergy, and Critical Care Medicine and the School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- D. Scott Batey, PhD, MSW, is an Associate Professor, School of Social Work, Tulane University, New Orleans, Louisiana, USA
- David E. Vance, PhD, MGS, is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Crystal Chapman Lambert
- Jun Y. Byun, PhD, MSN, is a Postdoctoral Fellow, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Crystal Chapman Lambert, PhD, MSPH, CRNP, FNP-BC, ACRN, is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Pariya L. Fazeli, PhD, is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Anand S. Iyer, MD, MSPH, is an Assistant Professor in the Division of Pulmonary, Allergy, and Critical Care Medicine and the School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- D. Scott Batey, PhD, MSW, is an Associate Professor, School of Social Work, Tulane University, New Orleans, Louisiana, USA
- David E. Vance, PhD, MGS, is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Pariya L Fazeli
- Jun Y. Byun, PhD, MSN, is a Postdoctoral Fellow, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Crystal Chapman Lambert, PhD, MSPH, CRNP, FNP-BC, ACRN, is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Pariya L. Fazeli, PhD, is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Anand S. Iyer, MD, MSPH, is an Assistant Professor in the Division of Pulmonary, Allergy, and Critical Care Medicine and the School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- D. Scott Batey, PhD, MSW, is an Associate Professor, School of Social Work, Tulane University, New Orleans, Louisiana, USA
- David E. Vance, PhD, MGS, is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Anand S Iyer
- Jun Y. Byun, PhD, MSN, is a Postdoctoral Fellow, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Crystal Chapman Lambert, PhD, MSPH, CRNP, FNP-BC, ACRN, is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Pariya L. Fazeli, PhD, is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Anand S. Iyer, MD, MSPH, is an Assistant Professor in the Division of Pulmonary, Allergy, and Critical Care Medicine and the School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- D. Scott Batey, PhD, MSW, is an Associate Professor, School of Social Work, Tulane University, New Orleans, Louisiana, USA
- David E. Vance, PhD, MGS, is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - D Scott Batey
- Jun Y. Byun, PhD, MSN, is a Postdoctoral Fellow, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Crystal Chapman Lambert, PhD, MSPH, CRNP, FNP-BC, ACRN, is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Pariya L. Fazeli, PhD, is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Anand S. Iyer, MD, MSPH, is an Assistant Professor in the Division of Pulmonary, Allergy, and Critical Care Medicine and the School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- D. Scott Batey, PhD, MSW, is an Associate Professor, School of Social Work, Tulane University, New Orleans, Louisiana, USA
- David E. Vance, PhD, MGS, is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - David E Vance
- Jun Y. Byun, PhD, MSN, is a Postdoctoral Fellow, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Crystal Chapman Lambert, PhD, MSPH, CRNP, FNP-BC, ACRN, is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Pariya L. Fazeli, PhD, is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Anand S. Iyer, MD, MSPH, is an Assistant Professor in the Division of Pulmonary, Allergy, and Critical Care Medicine and the School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- D. Scott Batey, PhD, MSW, is an Associate Professor, School of Social Work, Tulane University, New Orleans, Louisiana, USA
- David E. Vance, PhD, MGS, is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Palones E, Curto E, Plaza V, Gonzalez-Quereda L, Segarra-Casas A, Querol L, Bertoletti F, Rodriguez MJ, Gallano P, Crespo-Lessmann A. Clinical and functional characteristics, possible causes, and impact of chronic cough in patients with cerebellar ataxia, neuropathy, and bilateral vestibular areflexia syndrome (CANVAS). J Neurol 2024; 271:1204-1212. [PMID: 37917234 PMCID: PMC10896788 DOI: 10.1007/s00415-023-12001-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/09/2023] [Accepted: 09/11/2023] [Indexed: 11/04/2023]
Abstract
Cerebellar ataxia with neuropathy and bilateral vestibular areflexia syndrome (CANVAS) is an hereditary autosomal recessive disease. Recent studies propose including chronic cough (CC) as a symptom of CANVAS. For 10 patients with CANVAS as genetically confirmed by biallelic expansion of the AAGG repeat motif (AAGGGexp) in intron 2 of replication factor C subunit 1 (RFC1), our aim was, as a multidisciplinary team, to describe clinical and functional characteristics and possible causes of CC following European Respiratory Society (ERS) recommendations, and to evaluate CC impact on quality of life (QoL) using self-administered questionnaires (Cough Severity Diary, Leicester Cough Questionnaire, Discrete Emotions Questionnaire, and EQ-5D-5L). In all 10 patients, the CC was a dry cough that developed several years prior to the neurological symptoms (mean 14.2 years); 7 patients had symptoms compatible with gastroesophageal reflux (GER), 5 with pathological GER diagnosed by 24-h esophageal pH testing, and 6 patients had impaired esophageal motility diagnosed by high-resolution esophageal manometry, most frequently ineffective peristalsis. Although further studies are required for confirmation, we conclude that CC may be a characteristic prodrome of CANVAS and may be related to GER and esophageal disorders. Furthermore, CC affects patients' QoL, especially in the psychosocial sphere.
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Affiliation(s)
- Esther Palones
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
- Department of Respiratory Medicine, Sant Pau Biomedical Research Institute (IIB SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
| | - Elena Curto
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Department of Respiratory Medicine, Sant Pau Biomedical Research Institute (IIB SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Vicente Plaza
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Department of Respiratory Medicine, Sant Pau Biomedical Research Institute (IIB SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Lidia Gonzalez-Quereda
- Genetics Department, Institute of Biomedical Research Sant Pau (IIB SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Genetics and Microbiology Department, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Alba Segarra-Casas
- Genetics Department, Institute of Biomedical Research Sant Pau (IIB SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Genetics and Microbiology Department, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Luis Querol
- Neuromuscular Disease Unit, Department of Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Federico Bertoletti
- Department of Digestive Pathology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - María José Rodriguez
- Genetics Department, Institute of Biomedical Research Sant Pau (IIB SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Pía Gallano
- Genetics Department, Institute of Biomedical Research Sant Pau (IIB SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Genetics and Microbiology Department, Universitat Autònoma de Barcelona, Barcelona, Spain
- Networked Biomedical Research Centre for Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Astrid Crespo-Lessmann
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Department of Respiratory Medicine, Sant Pau Biomedical Research Institute (IIB SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
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5
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McGarvey LP, Harper G, Silvey M, Langerman H. A real world study of cough burden and quality of life of UK patients who have undergone evaluation for chronic cough. Curr Med Res Opin 2023; 39:1717-1728. [PMID: 37994434 DOI: 10.1080/03007995.2023.2284371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 11/13/2023] [Indexed: 11/24/2023]
Abstract
OBJECTIVE Treatment options for adults with chronic cough (CC) are limited. This study reports on the health status and experiences of patients with recent healthcare evaluation for CC. METHODS This prospective, UK, cross-sectional study surveyed adults with a CC evaluation within the previous 12 months. All were never smokers (or ex-smokers for ≥12 months). Subjects completed five validated patient-reported outcome measures: cough visual analogue scale (VAS), EuroQoL 5 dimension, 5 level (EQ-5D-5L), EQ-5D VAS, Leicester Cough Questionnaire (LCQ), and Work Productivity and Activity Impairment (WPAI) questionnaire. RESULTS A total of 101 participants were recruited: 71% were female, mean age was 54.9 ± 15.2 years. Median (IQR) CC duration was 36 (11, 120) months. Mean self-reported CC severity (Cough-VAS) was 51.3 ± 22.9 over the previous 2 weeks and 62.9 ± 23.7 on the worst day of coughing. EQ-5D values were lower for CC patients than population norms. Subanalyses revealed that EQ-5D and LCQ scores were significantly impacted by CC duration and the number of healthcare providers (HCPs) visited. WPAI analysis showed a 27.6% work time impairment because of participants' CC. The number of HCP attendances ranged from 1 to 10 (3.3 ± 2.8) before diagnosis was confirmed. Treatment was being prescribed to 87% of participants and comprised mainly steroids (nasal [19%] and inhaled [25%]), beta agonists (24%), and proton pump inhibitors (21%); 44% of patients were dissatisfied with treatment efficacy. CONCLUSION Real-world data from a nationally representative UK population show significant unmet needs associated with CC, including multiple healthcare visits and limited treatment effectiveness, resulting in inadequate cough control and impaired health status.
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Affiliation(s)
- Lorcan P McGarvey
- Wellcome-Wolfson Institute for Experimental Medicine, Queen's University, Belfast, UK
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Lee B, Kwon CY, Suh HW, Kim YJ, Kim KI, Lee BJ, Lee JH. Herbal medicine for the treatment of chronic cough: a systematic review and meta-analysis. Front Pharmacol 2023; 14:1230604. [PMID: 37920213 PMCID: PMC10619915 DOI: 10.3389/fphar.2023.1230604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 09/28/2023] [Indexed: 11/04/2023] Open
Abstract
Objectives: Chronic cough is a frequent condition worldwide that significantly impairs quality of life. Herbal medicine (HM) has been used to treat chronic cough due to the limited effectiveness of conventional medications. This study aimed to summarize and determine the effects of HM on patients with chronic cough. Methods: A comprehensive search of 11 databases was conducted to find randomized controlled clinical trials (RCTs) that reported the effects of HM for patients with chronic cough on 16 March 2023. The primary outcome was cough severity, and the secondary outcomes included cough-related quality of life, cough frequency, total effective rate (TER), and cough recurrence rate. The methodological quality of the included studies was assessed using the Cochrane risk of bias tool, and the certainty of the evidence for effect estimates was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations tool. Results: A total of 80 RCTs comprising 7,573 patients were included. When HM was used as an alternative therapy to conventional medication, there were inconsistent results in improving cough severity. However, HM significantly improved cough-related quality of life and TER and significantly lowered the cough recurrence rate compared with conventional medication. When used as an add-on therapy to conventional medication, HM significantly improved cough severity, cough-related quality of life, and TER and significantly lowered the recurrence rate. In addition, HM had a significantly lower incidence of adverse events when used as an add-on or alternative therapy to conventional medication. The subgroup analysis according to age and cause of cough also showed a statistically consistent correlation with the overall results. The certainty of the evidence for the effect of HM was generally moderate to low due to the risk of bias in the included studies. Conclusion: HM may improve cough severity and cough-related quality of life, and lower the cough recurrence rate and incidence of adverse events in patients with chronic cough. However, due to the high risk of bias and clinical heterogeneity of the included studies, further high-quality placebo-controlled clinical trials should be conducted using a validated and objective assessment tool. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023418736, CRD42023418736.
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Affiliation(s)
- Boram Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Chan-Young Kwon
- Department of Oriental Neuropsychiatry, Dong-eui University College of Korean Medicine, Busan, Republic of Korea
| | - Hyo-Weon Suh
- Health Policy Research Team, Division of Healthcare Research, National Evidence-based Healthcare Collaborating Agency, Seoul, Republic of Korea
| | - Ye Ji Kim
- Department of Korean Pediatrics, Kyung Hee University Medical Center, Seoul, Republic of Korea
| | - Kwan-Il Kim
- Division of Allergy, Immune and Respiratory System, Department of Internal Medicine, College of Korean Medicine, Kyung Hee Medical Center, Kyung Hee University, Seoul, Republic of Korea
| | - Beom-Joon Lee
- Division of Allergy, Immune and Respiratory System, Department of Internal Medicine, College of Korean Medicine, Kyung Hee Medical Center, Kyung Hee University, Seoul, Republic of Korea
| | - Jun-Hwan Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
- Korean Medicine Life Science, University of Science and Technology (UST), Campus of Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
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Jo EJ, Lee JH, Won HK, Kang N, Kang SY, Lee SE, Lee JH, Kim MY, Shim JS, An J, Yoo Y, Park SY, Kim BK, Moon JY, Park HK, Kim MH, Kwon HS, Kim SH, Kim SH, Chang YS, Kim SH, Birring SS, Lee BJ, Song WJ. Baseline Cohort Profile of the Korean Chronic Cough Registry: A Multicenter, Prospective, Observational Study. Lung 2023; 201:477-488. [PMID: 37658853 DOI: 10.1007/s00408-023-00644-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 08/19/2023] [Indexed: 09/05/2023]
Abstract
PURPOSE The Korean Chronic Cough Registry study was initiated to characterize patients with chronic cough (CC) and investigate their outcomes in real-world clinical practice. This report aims to describe the baseline cohort profile and study protocols. METHODS This multicenter, prospective observational cohort study included newly referred CC patients and those already being treated for refractory or unexplained chronic cough (RUCC). Cough status was assessed using a visual analog scale, the Leicester Cough Questionnaire (LCQ), and the Cough Hypersensitivity Questionnaire (CHQ). RESULTS A total of 610 patients (66.9% women; median age 59.0 years) were recruited from 18 centers, with 176 being RUCC patients (28.9%). The median age at CC onset was 50.1 years, and 94.4% had adult-onset CC (≥ 19 years). The median cough duration was 4 years. Compared to newly referred CC patients, RUCC patients had a longer cough duration (6.0 years vs. 3.0 years) but had fewer symptoms and signs suggesting asthma, rhinosinusitis, or gastroesophageal acid reflux disease. Subjects with RUCC had lower LCQ scores (10.3 ± 3.3 vs. 11.6 ± 3.6; P < 0.001) and higher CHQ scores (9.1 ± 3.9 vs. 8.4 ± 4.1; P = 0.024). There were no marked differences in the characteristics of cough between refractory chronic cough and unexplained chronic cough. CONCLUSIONS Chronic cough typically develops in adulthood, lasting for years. Cough severity and quality of life impairment indicate the presence of unmet clinical needs and insufficient cough control in real-world clinical practice. Longitudinal follow-up is warranted to investigate the natural history and treatment outcomes.
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Affiliation(s)
- Eun-Jung Jo
- Department of Internal Medicine, School of Medicine, Pusan National University, Busan, Korea
| | - Ji-Hyang Lee
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea
| | - Ha-Kyeong Won
- Department of Internal Medicine, Veterans Health Service Medical Center, Seoul, Korea
| | - Noeul Kang
- Division of Allergy, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, Korea
| | - Sung-Yoon Kang
- Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Seung Eun Lee
- Department of Internal Medicine, School of Medicine, Pusan National University, Busan, Korea
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Ji-Ho Lee
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Mi-Yeong Kim
- Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Ji-Su Shim
- Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Jin An
- Department of Pulmonary, Allergy and Critical Care Medicine, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Korea
| | - Youngsang Yoo
- Department of Internal Medicine, Gangneung Asan Hospital, Gangneung, Korea
| | - So-Young Park
- Department of Internal Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Byung-Keun Kim
- Division of Pulmonology, Allergy and Critical Care Medicine, Department of Internal Medicine, University College of Medicine, Seoul, Korea
| | - Ji-Yong Moon
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Han-Ki Park
- Department of Allergy and Clinical Immunology, School of Medicine, Kyungpook National University Chilgok Hospital, Kyungpook National University, Daegu, Korea
| | - Min-Hye Kim
- Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Hyouk-Soo Kwon
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea
| | - Sae-Hoon Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Sang-Heon Kim
- Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Yoon-Seok Chang
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Sang-Hoon Kim
- Department of Internal Medicine, Eulji University College of Medicine, Seoul, Korea
| | - Surinder S Birring
- Centre for Human & Applied Physiological Sciences, School of Basic & Medical Biosciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Byung-Jae Lee
- Division of Allergy, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, Korea.
| | - Woo-Jung Song
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea.
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Yang S, Huang S, Hincapie-Castillo JM, Ke X, Ding H, Schelfhout J, Sher MR, Jones B, Wilson DL, Lo-Ciganic WH. Patterns of Cough Medication Prescribing among Patients with Chronic Cough in Florida: 2012-2021. J Clin Med 2023; 12:6286. [PMID: 37834931 PMCID: PMC10573590 DOI: 10.3390/jcm12196286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 09/15/2023] [Accepted: 09/20/2023] [Indexed: 10/15/2023] Open
Abstract
Among patients with chronic cough (CC) in the 2012-2021 statewide OneFlorida Clinical Research Consortium database, we examined trends in cough medication (CM) prescribing prevalence over time in repeated cross-sectional analyses and identified distinct CM utilization trajectories using group-based trajectory modeling (GBTM) in a retrospective cohort study. Among eligible adults (≥18 years) without cancer/benign respiratory tumor diagnoses, we identified CC patients and non-CC patients with any cough-related diagnosis. In the GBTM analysis, we calculated the number of monthly prescriptions for any CMs (excluding gabapentinoids) during the 12 months from the first qualifying cough event to identify distinct utilization trajectories. From 2012 to 2021, benzonatate (9.6% to 26.1%), dextromethorphan (5.2% to 8.6%), and gabapentinoid (5.3% to 14.4%) use increased among CC patients, while opioid antitussive use increased from 2012 to 2015 and decreased thereafter (8.4% in 2012, 14.7% in 2015, 6.7% in 2021; all p < 0.001). Of 15,566 CC patients and 655,250 non-CC patients identified in the GBTM analysis, CC patients had substantial burdens of respiratory/non-respiratory comorbidities and healthcare service and concomitant medication use compared to non-CC patients. Among CC patients, GBTM identified three distinct CM utilization trajectories: (1) no CM use (n = 11,222; 72.1%); (2) declining CM use (n = 4105; 26.4%); and (3) chronic CM use (n = 239; 1.5%). CC patients in Florida had limited CM use with increasing trends in use of benzonatate, dextromethorphan, and gabapentinoids and a decreasing trend in opioid antitussive use. CC patients, particularly with chronic prescription CM use, experienced substantial disease burden.
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Affiliation(s)
- Seonkyeong Yang
- Department of Pharmaceutical Outcomes & Policy, College of Pharmacy, University of Florida, Gainesville, FL 32611, USA; (S.Y.); (S.H.); (B.J.); (D.L.W.)
| | - Shu Huang
- Department of Pharmaceutical Outcomes & Policy, College of Pharmacy, University of Florida, Gainesville, FL 32611, USA; (S.Y.); (S.H.); (B.J.); (D.L.W.)
| | - Juan M. Hincapie-Castillo
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA;
| | - Xuehua Ke
- Center for Observational and Real-World Evidence (CORE), Merck & Co., Inc., Rahway, NJ 07065, USA; (X.K.); (H.D.); (J.S.)
| | - Helen Ding
- Center for Observational and Real-World Evidence (CORE), Merck & Co., Inc., Rahway, NJ 07065, USA; (X.K.); (H.D.); (J.S.)
| | - Jonathan Schelfhout
- Center for Observational and Real-World Evidence (CORE), Merck & Co., Inc., Rahway, NJ 07065, USA; (X.K.); (H.D.); (J.S.)
| | | | - Bobby Jones
- Department of Pharmaceutical Outcomes & Policy, College of Pharmacy, University of Florida, Gainesville, FL 32611, USA; (S.Y.); (S.H.); (B.J.); (D.L.W.)
| | - Debbie L. Wilson
- Department of Pharmaceutical Outcomes & Policy, College of Pharmacy, University of Florida, Gainesville, FL 32611, USA; (S.Y.); (S.H.); (B.J.); (D.L.W.)
| | - Wei-Hsuan Lo-Ciganic
- Department of Pharmaceutical Outcomes & Policy, College of Pharmacy, University of Florida, Gainesville, FL 32611, USA; (S.Y.); (S.H.); (B.J.); (D.L.W.)
- Center for Drug Evaluation and Safety (CoDES), College of Pharmacy, University of Florida, Gainesville, FL 32610, USA
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9
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Puente-Maestu L, Dávila I, Quirce S, Crespo-Lessmann A, Martínez-Moragón E, Sola J, Nieto ML, González-Barcala FJ, Cea-Calvo L, Sánchez-Jareño M, Rivas-Pardinas C, Domingo C. Burden of refractory and unexplained chronic cough on patients' lives: a cohort study. ERJ Open Res 2023; 9:00425-2023. [PMID: 37753282 PMCID: PMC10518856 DOI: 10.1183/23120541.00425-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 08/02/2023] [Indexed: 09/28/2023] Open
Abstract
Background Chronic cough (cough lasting for ≥8 weeks) can lead to significant impairment in quality of life (QoL). Using patient-reported outcomes, this cohort study assessed the perceived impact of chronic cough on QoL and everyday life in patients from outpatient hospital clinics with refractory chronic cough (RCC) or unexplained chronic cough (UCC). Methods This was a multicentre, non-interventional survey study. Cough severity was assessed on a 0-100 mm Visual Analogue Scale (VAS). Frequency, intensity and disruptiveness of cough were assessed using an adaptation of the Cough Severity Diary. The impact of cough on QoL was assessed using the Leicester Cough Questionnaire (LCQ). The physical impact of cough and associated impact on everyday life activities were explored using purpose-designed questions. Results 191 patients responded to the survey; 121 (63.4%) had RCC and 149 were women (78.0%). Mean score on the cough severity VAS was 62.9 mm. Mean LCQ total score of 11.9 indicated reduced QoL. Cough impaired patients' everyday life, including the inability to speak fluently (58.0% of patients) and feeling tired/drained (46.6%). Women perceived poorer chronic cough-related QoL than men, as reflected by lower LCQ scores, and greater impairment of physical health, including cough-related stress urinary incontinence, and psychological health. Conclusions Patients with RCC/UCC experience a significant burden in their everyday life, including impaired QoL, and perceive a negative impact on physical and psychological health and everyday activities, affecting work, relationships and leisure activities. The impact appears to be greater in women than men for several of the aspects studied.
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Affiliation(s)
- Luis Puente-Maestu
- Servicio de Neumología, Hospital Universitario Gregorio Marañón, UCM, Madrid, Spain
| | - Ignacio Dávila
- Servicio de Alergia, Hospital Universitario de Salamanca, Departamento de Ciencias Biomédicas y del Diagnóstico, Facultad de Medicina, Universidad de Salamanca, Salamanca, Spain
| | - Santiago Quirce
- Servicio de Alergia, Hospital Universitario La Paz, Madrid, Spain
| | - Astrid Crespo-Lessmann
- Servicio de Neumología y Alergia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | - Javier Sola
- Servicio de Alergia, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | | | - Francisco Javier González-Barcala
- Grupo de Investigación Traslacional en Enfermedades de las Vías Aéreas (TRIAD); Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS); Departamento de Medicina, Universidad de Santiago de Compostela; Departamento de Medicina Respiratoria, Hospital Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | | | | | | | - Christian Domingo
- Servicio de Neumología, Corporació Parc Taulí, Universitat Autònoma de Barcelona (UAB), Sabadell, Spain
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10
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Guilleminault L, Demoulin-Alexikova S, de Gabory L, Varannes SBD, Brouquières D, Balaguer M, Chapron A, Grassin-Delyle S, Poussel M, Guibert N, Reychler G, Trzepizur W, Woisard V, Crestani S. Guidelines for the management of chronic cough in adults. Endorsed by the French speaking society of respiratory diseases (Société de Pneumologie de Langue Française, SPLF), the Société Française d'Oto-Rhino-Laryngologie et de Chirurgie de la Face et du Cou (SFORL), the Société Française de Phoniatrie et de Laryngologie (SFPL), the Société Nationale Française de Gastro-entérologie (SNFGE). Respir Med Res 2023; 83:101011. [PMID: 37087905 DOI: 10.1016/j.resmer.2023.101011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 03/12/2023] [Indexed: 03/29/2023]
Abstract
Patients with chronic cough experience a high alteration of quality of life. Moreover, chronic cough is a complex entity with numerous etiologies and treatments. In order to help clinicians involved in the management of patients with chronic cough, guidelines on chronic cough have been established by a group of French experts. These guidelines address the definitions of chronic cough and the initial management of patients with chronic cough. We present herein second-line tests that might be considered in patients with cough persistence despite initial management. Experts also propose a definition of unexplained or refractory chronic cough (URCC) in order to better identify patients whose cough persists despite optimal management. Finally, these guidelines address the pharmacological and non-pharmacological interventions useful in URCC. Thus, amitryptilline, pregabalin, gabapentin or morphine combined with speech and/or physical therapy are a mainstay of treatment strategies in URCC. Other treatment options, such as P2 × 3 antagonists, are being developed.
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Affiliation(s)
- Laurent Guilleminault
- Pôle des voies respiratoires, service de pneumo-allergologie, Centre Hospitalo-Universitaire de Toulouse, 24 chemin de pouvourville, 31059, Toulouse, France; Toulouse Institute for Infectious and Inflammatory Diseases (Infinity), Inserm U1291, University of Toulouse, CNRS U5282, 31000, Toulouse, France.
| | - Silvia Demoulin-Alexikova
- CHU de Lille, Lille, France Univ. Lille, CNRS, Inserm, CHU Lille - Service des Explorations Fonctionnelles Respiratoires, Institut Pasteur de Lille, U1019-UMR9017-CIIL-Centre d'Infection et d'Immunité de Lille, 59000, Lille, France
| | - Ludovic de Gabory
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital of Bordeaux, Bordeaux, Univ. Bordeaux, 33000, France
| | - Stanislas Bruley Des Varannes
- Gastroenterology Department, CHU de Nantes, Institut des Maladies de l'Appareil Digestif, IMAD CIC 1413, Université de Nantes, 44000, Nantes, France
| | - Danielle Brouquières
- Pôle des voies respiratoires, service de pneumo-allergologie, Centre Hospitalo-Universitaire de Toulouse, 24 chemin de pouvourville, 31059, Toulouse, France
| | - Mathieu Balaguer
- Unité de voie et déglutition, hôpital Larrey, CHU de Toulouse, Toulouse, France
| | - Anthony Chapron
- Université de Rennes 1, CHU Rennes, Département de Médecine Générale, 35000, Rennes, France
| | - Stanislas Grassin-Delyle
- Respiratory Diseases Department, Foch Hospital, 92150, Suresnes, France; Infection and Inflammation, Health Biotechnology Department, Paris-Saclay University, UVSQ, INSERM, 78180, Montigny le Bretonneux, France
| | - Mathias Poussel
- CHRU-Nancy, Exploration Fonctionnelle Respiratoire-Centre Universitaire de Médecine du Sport et Activités Physiques Adaptées, F54000, Nancy, France; DevAH, Université de Lorraine, F54000, Nancy, France
| | - Nicolas Guibert
- Pôle des voies respiratoires, service de pneumo-allergologie, Centre Hospitalo-Universitaire de Toulouse, 24 chemin de pouvourville, 31059, Toulouse, France
| | | | - Wojciech Trzepizur
- Department of Respiratory and Sleep Medicine, Angers University Hospital, INSERM 1083, UMR CNRS 6015, MITOVASC, Equipe CarME, SFR ICAT, University of Angers, 49000, Angers, France
| | - Virginie Woisard
- Unité de voie et déglutition, hôpital Larrey, CHU de Toulouse, Toulouse, France
| | - Sabine Crestani
- Unité de voie et déglutition, hôpital Larrey, CHU de Toulouse, Toulouse, France
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11
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Guilleminault L, Demoulin-Alexikova S, de Gabory L, Bruley des Varannes S, Brouquières D, Balaguer M, Chapron A, Grassin Delyle S, Poussel M, Guibert N, Reychler G, Trzepizur W, Woisard V, Crestani S. [Guidelines for the management of chronic cough in adults]. Rev Mal Respir 2023; 40:432-452. [PMID: 37080877 DOI: 10.1016/j.rmr.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 03/03/2023] [Indexed: 04/22/2023]
Abstract
Patients with chronic cough experience major alteration in their quality of life. Given its numerous etiologies and treatments, this disease is a complex entity. To help clinicians involved in patient management of patients, guidelines have been issued by a group of French experts. They address definitions of chronic cough and initial management of patients with this pathology. We present herein the second-line tests that might be considered in patients whose coughing has persisted, notwithstanding initial management. The experts have also put forward a definition of unexplained or refractory chronic cough (URCC), the objective being to more precisely identify those patients whose cough persists despite optimal management. Lastly, these guidelines indicate the pharmacological and non-pharmacological interventions of use in URCC. Amitriptyline, pregabalin, gabapentin or morphine combined with speech and/or physical therapy are mainstays in treatment strategies. Other treatment options, such as P2X3 antagonists, are being developed and have generated high hopes among physicians and patients alike.
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Affiliation(s)
- L Guilleminault
- Pôle des voies respiratoires, service de pneumo-allergologie, centre hospitalo-universitaire de Toulouse, Toulouse, France; Institut toulousain des maladies infectieuses et inflammatoires (Infinity) INSERM UMR1291, CNRS UMR5051, université de Toulouse III, Toulouse, France.
| | - S Demoulin-Alexikova
- CHU de Lille, Lille, France; Inserm, CNRS, U1019-UMR9017, service des explorations fonctionnelles respiratoires, centre d'infection et d'immunité de Lille (CIIL), Institut Pasteur de Lille, university Lille, CHU Lille, Lille, France
| | - L de Gabory
- Department of otorhinolaryngology - head and neck surgery, university hospital of Bordeaux, Bordeaux, France; University of Bordeaux, 33000 Bordeaux, France
| | - S Bruley des Varannes
- IMAD CIC 1413, gastroenterology department, Institut des maladies de l'appareil digestif, université de Nantes, CHU de Nantes, Nantes, France
| | - D Brouquières
- Pôle des voies respiratoires, service de pneumo-allergologie, centre hospitalo-universitaire de Toulouse, Toulouse, France
| | - M Balaguer
- Unité de voie et déglutition, hôpital Larrey, CHU de Toulouse, Toulouse, France
| | - A Chapron
- Département de médecine générale, université de Rennes 1, CHU Rennes, Rennes, France
| | - S Grassin Delyle
- Respiratory diseases department, Foch hospital, Suresnes, France; Inserm, UVSQ, infection and inflammation, health biotechnology department, Paris-Saclay university, Montigny-le-Bretonneux, France
| | - M Poussel
- Exploration fonctionnelle respiratoire, centre universitaire de médecine du sport et activités physiques adaptées, CHRU de Nancy, 54000 Nancy, France; DevAH, université de Lorraine, 54000 Nancy, France
| | - N Guibert
- Pôle des voies respiratoires, service de pneumo-allergologie, centre hospitalo-universitaire de Toulouse, Toulouse, France
| | - G Reychler
- Université catholique de Louvain, Louvain, Belgique
| | - W Trzepizur
- Department of respiratory and sleep medicine, Angers university hospital, Angers, France; Inserm 1083, UMR CNRS 6015, MITOVASC, équipe CarME, SFR ICAT, university of Angers, 49000 Angers, France
| | - V Woisard
- Unité de voie et déglutition, hôpital Larrey, CHU de Toulouse, Toulouse, France
| | - S Crestani
- Unité de voie et déglutition, hôpital Larrey, CHU de Toulouse, Toulouse, France
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12
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Kang N, Won HK, Lee JH, Shim JS, Kang SY, Park HK, Jo EJ, Lee SE, Kim MH, Kim SH, Kim SH, Chang YS, Lee BJ, Song WJ, Jo MW. Health-Related Quality of Life and Its Determinants in Chronic Cough: The Korean Chronic Cough Registry Study. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2023; 15:348-360. [PMID: 37075795 DOI: 10.4168/aair.2023.15.3.348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 10/25/2022] [Accepted: 11/22/2022] [Indexed: 05/17/2023]
Abstract
PURPOSE Chronic cough (CC) is associated with health-related quality of life (HRQoL) impairment. However, the determinants of HRQoL are under-investigated. METHODS Patients aged 19-80 years with CC were prospectively recruited from 10 referral clinics. Comparisons were made with age- and sex-matched controls (1:4 ratio) selected from a Korean general population survey database; 1) a group without current cough (non-cough controls) and 2) another group without major chronic illnesses (healthy controls). HRQoL was assessed using the EuroQoL 5-dimension (EQ-5D) index. In CC patients, cough-specific patient-reported outcomes (PROs) were additionally measured. Cross-sectional analyses were performed to evaluate demographic and clinical parameters associated with the EQ-5D index of CC patients. RESULTS A total of 200 CC patients (137 newly referred with CC and 63 refractory or unexplained CC [RUCC] patients), 800 non-cough controls, and 799 healthy controls were analyzed. The EQ-5D index of CC patients was significantly lower than that of non-cough controls or healthy controls (0.82 ± 0.14 vs 0.92 ± 0.14/0.96 ± 0.08; P < 0.001, respectively). The index was also associated with older age (≥ 60 years), female sex, and comorbidities such as asthma or depression. Among the patients with CC, the index was significantly lower in patients with RUCC than in those with newly referred CC, being treated with codeine or cough neuromodulators, or with cough-related fatigue. In Spearman analyses, the EQ-5D index correlated with cough-specific quality of life and cough severity scores, not with throat sensation or cough trigger scores. CONCLUSIONS The HRQoL impairment of CC patients was associated with older age, female sex, and comorbidities but it was also affected by cough severity, complications, treatments, and treatment responses. Longitudinal studies are warranted to further understand and improve the HRQoL of CC patients.
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Affiliation(s)
- Noeul Kang
- Division of Allergy, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ha-Kyeong Won
- Department of Internal Medicine, Veterans Health Service Medical Center, Seoul, Korea
| | - Ji-Hyang Lee
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ji-Su Shim
- Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Sung-Yoon Kang
- Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Han-Ki Park
- Department of Allergy and Clinical Immunology, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Eun-Jung Jo
- Department of Internal Medicine, Pusan National University College of Medicine, Busan, Korea
| | - Seung Eun Lee
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Min-Hye Kim
- Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Sang-Heon Kim
- Department of Internal Medicine, Hanyang University Hospital, Hanyang University College of Medicine, Seoul, Korea
| | - Sae-Hoon Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Yoon-Seok Chang
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Byung-Jae Lee
- Division of Allergy, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Woo-Jung Song
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
| | - Min-Woo Jo
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea.
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13
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Yu CJ, Song WJ, Kang SH. The disease burden and quality of life of chronic cough patients in South Korea and Taiwan. World Allergy Organ J 2022; 15:100681. [PMID: 36119656 PMCID: PMC9463600 DOI: 10.1016/j.waojou.2022.100681] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 07/01/2022] [Accepted: 07/21/2022] [Indexed: 01/12/2023] Open
Abstract
Background Chronic cough (CC) is a common condition, but the burden of CC in general populations remains largely unknown. This study aims to investigate the disease prevalence and burden among community-based CC patients in South Korea and Taiwan, using structured tools. Methods A population-based cross-sectional study uses data from the 2020 South Korea and Taiwan National Health and Wellness Survey (NHWS) as well as a CC survey conducted between January–February 2020 and March–April 2020, respectively. Health outcome measures included health-related quality of life (HRQoL), health state utilities, work productivity and activity impairment (WPAI), and measurement of depression, anxiety, and insomnia among CC patients. Results The weighted lifetime and 12-month prevalence of CC was 6.20% and 4.34% in South Korea, and 8.27% and 5.55% in Taiwan. Compared to matched non-CC controls, CC patients reported poorer HRQoL (SF-12v2) in terms of physical component summary (PCS) score (South Korea: 47.69 ± 7.68 vs. 50.08 ± 7.29; Taiwan: 48.58 ± 7.15 vs. 50.50 ± 7.30) and mental component summary (MCS) score (44.15 ± 8.85 vs. 46.28 ± 8.50; 42.44 ± 7.78 vs. 44.60 ± 8.08), health state utilities EQ-5D index (0.73 ± 0.23 vs. 0.82 ± 0.16; 0.82 ± 0.13 vs. 0.86 ± 0.14), and more visits to healthcare professionals (7.80 vs. 4.61; 6.09 vs. 4.20) (p < 0.05). In terms of WPAI, CC patients reported higher impairments in presenteeism (32.8% vs. 21.0%; 25.9% vs. 19.4%), total work productivity (36.2% vs. 22.3%; 27.7% vs. 20.6%), and total activity (34.2% vs. 23.2%; 27.7% vs. 20.3%) than non-CC controls (p < 0.001). CC patients in South Korea and Taiwan experienced anxiety, depression, and insomnia more than non-CC controls. Poorer health outcomes were associated with the severity of CC. Patients with severe CC (visual analogue scale [VAS]>4) in both nations reported lower PCS score (45.80 vs. 49.48; 47.41 vs. 49.22) and higher absenteeism (8.5% vs. 3.6%; 5.5% vs. 1.8%) than patients with mild CC (VAS≤4) (p < 0.05). Conclusions The findings revealed that the disease burden of CC in general populations of South Korea and Taiwan is considerable with a negative impact on the overall quality of life, social and work life, and psychological comorbidities and is significantly associated with increased severity of the CC. There is an unmet need for further treatment interventions for CC patients to relieve the burden of CC in both nations.
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Affiliation(s)
- Chong-Jen Yu
- Department of Internal Medicine, and Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Woo-Jung Song
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
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Sykes DL, Zhang M, Morice AH. Treatment of chronic cough: P2X3 receptor antagonists and beyond. Pharmacol Ther 2022; 237:108166. [DOI: 10.1016/j.pharmthera.2022.108166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/22/2022] [Accepted: 03/02/2022] [Indexed: 10/18/2022]
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15
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Cough Presentation and Cough-Related Healthcare Utilization in Tertiary Care: Analysis of Routinely Collected Academic Institutional Database. Lung 2022; 200:431-439. [PMID: 35810219 DOI: 10.1007/s00408-022-00555-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 06/26/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE Routinely collected data (RCD) from electronic health records (EHR) are useful for studying disease epidemiology in the real world. We examined cough presentation and cough-related healthcare utilization using an academic institutional EHR database in Korea. METHODS In this retrospective cohort study, patients with subacute (3-8 weeks) or chronic cough (> 8 weeks in duration) referred to allergy and asthma clinics were studied. Cases were identified using the search term "cough" or "coughing," which is the chief complaint, in the data fields. Structured data, including demographics, medical history, symptoms, and diagnostic tests, were analyzed. Healthcare utilization was assessed for drug prescriptions, additional tests, or outpatient visits for 1 year. RESULTS Cough was the chief complaint in 13,223 cases (46.7%) among 28,312 new referrals for 8 years. A total of 3810 subacute and 7150 chronic cough patients were analyzed. The common demographic profile was middle-aged woman (mean age 52.1 years), reported in 63% of the cases. Cough was frequently accompanied by anterior nasal (about 50%), lower airway (30%), or acid reflux disease symptoms (20%), and by test abnormalities in chest X-rays (14%), spirometry (23%), or T2 inflammation markers (40%). Chronic cough patients frequently required additional tests (chest CT scan: 24%), drug prescriptions (codeine: 21.5% and oral steroids: 9.9%), and long-term healthcare utilization (16.0%) for 1 year. CONCLUSIONS Cough is a common chief complaint at allergy and asthma clinics, but the clinical presentation may be heterogeneous. Further studies are needed to understand long-term outcomes and reduce the disease burden.
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De Vincentis A, Baldi F, Calderazzo M, Caliceti U, Guarnieri G, Lombardi F, Lombardo FP, Maggi S, Onder G, Vaghi A, Zanasi A, Antonelli Incalzi R. Chronic cough in adults: recommendations from an Italian intersociety consensus. Aging Clin Exp Res 2022; 34:1529-1550. [PMID: 35666453 DOI: 10.1007/s40520-022-02154-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 05/11/2022] [Indexed: 12/18/2022]
Abstract
BACKGROUND Chronic cough (CC) is a burdensome health problem in adult and older people, with a major impact on quality of life. Its management is often troublesome, and many guidelines have been released. Notwithstanding, a proportion of cases still do not reach a definite diagnosis and resolutive treatment. A coordinated approach between different specialists would be highly recommended, but its implementation in clinical practice suffers from the lack of shared protocols and poor awareness of the problem. The present consensus document has been implemented to address these issues. AIMS To develop evidence-based recommendations for the management of adults with CC. METHODS A 12-member expert task force of general practitioners, geriatricians, pneumologists, allergologists, otorhynolaringologists and gastroenterologists was established to develop evidence-based recommendations for the diagnostic and therapeutic approach to subjects with CC. A modified Delphi approach was used to achieve consensus, and the US Preventive Services Task Force system was used to rate the strength of recommendations and the quality of evidence. RESULTS A total of 56 recommendations were proposed, covering 28 topics and concerning definitions and epidemiology, pathogenesis and etiology, diagnostic and therapeutic approach along with the consideration of specific care settings. CONCLUSION These recommendations should ease the management of subjects with CC by coordinating the expertise of different specialists. By providing a convenient list of topics of interest, they might assist in identifying unmet needs and research priorities.
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Affiliation(s)
- Antonio De Vincentis
- Unit of Internal Medicine and Geriatrics, Università Campus Bio-Medico di Roma, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, via Alvaro del Portillo, 200, 00128, Rome, Italy.
| | - Fabio Baldi
- Gastroenterology and Digestive Pathophysiology, Villalba Hospital, Bologna, Italy
| | | | - Umberto Caliceti
- Emeritus Professor of Otorhinolaringology, Università di Bologna, Bologna, Italy
| | - Gabriella Guarnieri
- Department of Cardiac-Thoracic-Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Francesco Lombardi
- Fondazione Policlinico IRCCS A. Gemelli, and Università Cattolica del Sacro Cuore, Roma, Italia
| | - Francesco Paolo Lombardo
- General Practitioner, Società Italiana di Medicina Generale (SIMG), Pneumology Area, Florence, Italy
| | - Stefania Maggi
- Institute of Neuroscience, Aging Branch, CNR, Padua, Italy
| | - Graziano Onder
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Ageing, Istituto Superiore di Sanità, Rome, Italy
| | - Adriano Vaghi
- ASST-Rhodense, UOC Pneumologia, Garbagnate Milanese, Milan, Italy
| | | | - Raffaele Antonelli Incalzi
- Unit of Internal Medicine and Geriatrics, Università Campus Bio-Medico di Roma, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, via Alvaro del Portillo, 200, 00128, Rome, Italy
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Huang K, Gu X, Yang T, Xu J, Yang L, Zhao J, Zhang X, Bai C, Kang J, Ran P, Shen H, Wen F, Chen Y, Sun T, Shan G, Lin Y, Wu S, Wang R, Shi Z, Xu Y, Ye X, Song Y, Wang Q, Zhou Y, Li W, Ding L, Wan C, Yao W, Guo Y, Xiao F, Lu Y, Peng X, Xiao D, Bu X, Zhang H, Zhang X, An L, Zhang S, Cao Z, Zhan Q, Yang Y, Liang L, Dai H, Cao B, He J, Chung KF, Wang C. Prevalence and burden of chronic cough in China: a national cross-sectional study. ERJ Open Res 2022; 8:00075-2022. [PMID: 35898809 PMCID: PMC9309344 DOI: 10.1183/23120541.00075-2022] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 03/16/2022] [Indexed: 11/30/2022] Open
Abstract
Background Chronic cough is a common complaint, but there are no population-based data on its burden in China. We determined the prevalence of chronic cough and its impact on health status in adults stratified by sex, age and the diagnosis of COPD or the presence of small airway dysfunction (SAD). Methods A representative sample of 57 779 Chinese adults aged 20 years or older was recruited and pulmonary function test was measured. Chronic cough was defined as cough lasting for >3 months in each year. Quality of life was assessed by the 12-item Short Form Health Survey (SF-12), and self-reported history of hospital visits was recorded. Results Chronic cough was found in 3.6% (95% CI 3.1–4.1) of Chinese adults, 2.4% (95% CI 1.9–3.1) of those aged 20–49 years and 6.0% (95% CI 5.3–6.8) of those aged 50 years or older. Individuals with chronic cough had an impaired physical component summary (PCS) score of the SF-12 (p<0.0001) and more emergency visits (p=0.0042) and hospital admissions (p=0.0002). Furthermore, the impact of chronic cough on PCS score was more significant in those aged 50 years or older, or with COPD (p=0.0018 or 0.0002, respectively), with the impact on hospital admission being more significant in those with COPD or with SAD (p=0.0026 or 0.0065, respectively). Conclusions Chronic cough is prevalent in China and is associated with a poorer health status, especially in individuals aged 50 years or older and those with the diagnosis of COPD or SAD. In the general adult population in China, chronic cough is prevalent and associated with poorer health status, especially in individuals aged ≥50 years and those with COPD or small airway dysfunctionhttps://bit.ly/3785LYZ
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Arinze JT, Hofman A, de Roos EW, de Ridder MAJ, Verhamme KMC, Stricker B, Brusselle GG, Luik AI. The interrelationship of chronic cough and depression: a prospective population-based study. ERJ Open Res 2022; 8:00069-2022. [PMID: 35402604 PMCID: PMC8982749 DOI: 10.1183/23120541.00069-2022] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 02/07/2022] [Indexed: 11/12/2022] Open
Abstract
Background Chronic cough is a debilitating medical condition that is often complicated by psychomorbidities such as depressive symptoms. Nevertheless, little is known about the impact of chronic cough on the risk of developing depression. Therefore, we investigated the association between chronic cough and prevalent, incident and recurrent depression in a population-based sample of middle-aged and older persons. Methods Within the Rotterdam Study, a population-based cohort, we defined chronic cough as reporting daily coughing for ⩾3 months. Depression was assessed using the Center for Epidemiologic Studies Depression scale, clinical interviews and medical records. Associations between chronic cough and depression were determined with linear, logistic and Cox regression analyses. Results The study included 5877 participants (mean±sd age 72±8 years, 59% female) who contributed 37 287 person-years of follow-up. At baseline, participants with chronic cough reported more depressive symptoms (adjusted standardised mean difference 0.15, 95% CI 0.07–0.22) compared to those without chronic cough. Over time, chronic cough was associated with an increased risk of depression in participants with a history of depression (hazard ratio (HR) 1.45, 95% CI 1.13–1.84), but not in those without a history of depression (HR 0.91, 95% CI 0.68–1.22). Conclusions Adults with chronic cough have a disproportionate burden of depressive symptoms and an increased risk of recurrent depression. This highlights the importance of screening for depression in patients with chronic cough. Adults with chronic cough have a disproportionate burden of depressive symptoms and are more likely to suffer recurrent depression, highlighting the need for screening for depression in individuals with chronic coughhttps://bit.ly/3sPvYTd
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Liang H, Ye W, Wang Z, Liang J, Yi F, Jiang M, Lai K. Prevalence of chronic cough in China: a systematic review and meta-analysis. BMC Pulm Med 2022; 22:62. [PMID: 35151307 PMCID: PMC8840780 DOI: 10.1186/s12890-022-01847-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 01/31/2022] [Indexed: 12/13/2022] Open
Abstract
Background Individual studies have indicated variable prevalence for chronic cough, but thus far, there has been no systematic report on the prevalence of this condition. Methods In this study, we performed a systematic review and meta-analysis by searching databases including PubMed, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Chinese biomedical literature service system, Wanfang Database, and VIP database, for studies on chronic cough in China published before December 28, 2020. A random effects model was used to calculate pooled prevalence estimates with 95% confidence interval [95%CI], weighted by study size. Results Fifteen studies with 141,114 community-based adults were included in the study, showing a prevalence of 6.22% (95% CI 5.03–7.41%). And 21 studies with 164,280 community-based children were included, presenting a prevalence of 7.67% (95% CI 6.24–9.11%). In subgroup meta-analyses, the prevalence in adults was 4.38% (95% CI 2.74–6.02%) in southern China and 8.70% (95% CI 6.52–10.88%) in northern China. In the children population, the prevalence in northern China was also higher than in southern China (northern vs. southern: 7.45% with a 95% CI of 5.50–9.41%, vs. 7.86% with a 95% CI of 5.56–10.16%). Conclusions Our population-based study provides relatively reliable data on the prevalence of chronic cough in China and may help the development of global strategies for chronic cough management. Supplementary Information The online version contains supplementary material available at 10.1186/s12890-022-01847-w.
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Song WJ, Yu CJ, Kang SH. Cough Characteristics and Healthcare Journeys of Chronic Cough Patients in Community-Based Populations in South Korea and Taiwan. Lung 2022; 200:725-736. [PMID: 36329168 PMCID: PMC9675671 DOI: 10.1007/s00408-022-00586-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 10/18/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE This study aimed to understand the cough characteristics and health journeys among community-based chronic cough (CC) patients, and their characteristics associated with healthcare visits. METHODS A population-based cross-sectional study was conducted in 2020, using the South Korea and Taiwan National Health and Wellness Survey (NHWS) and CC surveys. Patients with current CC were defined by daily coughing for > 8 weeks in the past 12 months and currently coughing at the time of survey. The survey items pertained to CC patients' treatment journey and cough characteristics. RESULTS Patients with current CC in South Korea and Taiwan, respectively, had cough duration for 3.45 ± 5.13 years and 5.75 ± 7.28 years and cough severity visual analogue scale (VAS) scores of 4.50 ± 2.15 and 4.46 ± 1.92 out of 0-10 scale, with 70.3% and 57.9% having spoken with a physician about cough. Compared to CC patients who had not visited healthcare professionals for cough, those who visited reported more severe cough (VAS: 3.89 ± 1.71 vs. 4.6 ± 2.02; p = 0.009), worse cough-specific quality of life (Leicester Cough Questionnaire: 16.20 ± 3.23 vs.13.45 ± 2.68, p < 0.001), greater symptom severity (Hull Airway Reflux Questionnaire: 16.73 ± 15.16 vs. 24.57 ± 13.38; p < 0.001), and more urinary incontinence (13.6 vs. 26.5%, p = 0.027). More than 50% of patients perceived cough medication(s) as not or a little useful and 25% felt their physicians did not well understand how CC impacts their life. CONCLUSION Cough is frequently severe and persistent among community-based CC patients. They experience several issues in their health journey, including treatment ineffectiveness and physician's understanding. Further efforts are warranted to reduce CC burden in the community.
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Affiliation(s)
- Woo-Jung Song
- grid.267370.70000 0004 0533 4667Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chong-Jen Yu
- grid.412094.a0000 0004 0572 7815Department of Internal Medicine, and Graduate Institute of Clinical Medicine, National Taiwan University Hospital, Hsin-Chu Branch and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Suk Hyun Kang
- grid.497677.c0000000406477176Market Access, MSD, Seoul, Korea
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21
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Domínguez-Ortega J, Plaza V, Li VW, Fonseca E, Cea-Calvo L, Martin A, Sánchez-Jareño M, Brady JE, Schelfhout J. Prevalence of chronic cough and patient characteristics in adults in Spain: A population-based cross-sectional survey. Chron Respir Dis 2022; 19:14799731221098722. [PMID: 35620851 PMCID: PMC9150240 DOI: 10.1177/14799731221098722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background Chronic cough (CC) represents a significant health burden. This study assessed the prevalence of CC (defined as per international guidelines as cough duration >8 weeks) in Spanish adults and compared characteristics between CC and non-CC cohorts. Methods CC cohorts were compiled using data from adult respondents to the 2020 Spanish cross-sectional online National Health and Wellness Survey (NHWS). Using propensity scores, respondents experiencing CC during their lifetime and the previous 12 months were matched 3:1 to respondents without CC and their health characteristics were compared. The number of Spanish adults affected with CC was estimated using weighted CC prevalence. Results CC during their lifetime or the previous 12 months was experienced by 579 (8.2%) and 389 (5.5%) of 7074 NHWS respondents, of whom 233 (38.5%) and 171 (44.0%), respectively, had physician-diagnosed CC. Based on weighted prevalence rates, lifetime and 12-month CC were estimated to affect ≈3.3 million and ≈2.2 million Spanish adults, respectively. Relative to the non-CC cohort, the 12-month CC cohort consistently demonstrated poorer health status, poorer mental health, greater healthcare utilization, and lower productivity at work and home. Conclusion This study contributes novel data regarding the prevalence of CC in Spain, suggests that CC is underdiagnosed, and reflects that CC and related comorbidities inflict a significant health burden in the affected population.
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Affiliation(s)
- Javier Domínguez-Ortega
- Allergy Department, La Paz University Hospital, IdiPAZ, Madrid, Spain.,CIBER of Respiratory Diseases, CIBERES, Madrid, Spain
| | - Vicente Plaza
- CIBER of Respiratory Diseases, CIBERES, Madrid, Spain.,Respiratory Medicine Department, Santa Creu i Sant Pau Hospital, Barcelona, Spain.,Medicine Department, University Autonomous of Barcelona (UAB), Barcelona, Spain
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Shen HQ, Zhang YH, Zhang J, Sheng QM. Process of diagnosis and treatment of chronic cough in children at primary hospitals. Front Pediatr 2022; 10:1018924. [PMID: 36589155 PMCID: PMC9795405 DOI: 10.3389/fped.2022.1018924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 11/28/2022] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE This study aimed to establish a process for the diagnosis and treatment of chronic cough in children suitable at primary hospitals and improve the treatment efficacy rate and improve health economic indicators. METHODS Children who visited the Department of Pediatrics, Affiliated Zhou Pu Hospital of the Shanghai Health Medical College from January to December 2021 were randomly assigned to the intervention group (n = 206), in which the diagnosis and treatment process proposed here was applied, and a control group (n = 211) that did not follow the intervention pathway and followed a pathway with the doctors usual practice based on his/her previous experience. Patients were followed up and data were collected at weeks 0 (time of enrollment), 2, 4, 8, and 12 to evaluate the efficacy rate and clinical value. RESULTS (1) No significant differences were detected between the two groups in baseline characteristics, including gender, age, duration of cough (weeks), history of allergy in children and parents, and smoking of family members living in the same household (p > 0.05); (2) During the follow-up, all cough symptom scores of the intervention group were lower than the control group. Additionally, at week 12, the treatment efficacy rate of the intervention group (91.70%) was significantly higher than the control group (69.20%) (p < 0.05); (3) The quality of life of children in both groups at week 12 was improved compared to the first visit. However, the total score of the intervention group was significantly higher than the control group (p < 0.05); (4) At week 12, the referral rate was significantly lower in the intervention group (11.17%) than in the control group (21.33%); (5) The intervention group was better than the control group for the mean monthly medication costs, number of days on errors in childhood, and number of days mistakenly worked by family members at week 12 (p < 0.05). CONCLUSION The current process of diagnosis and treatment of chronic cough in children at primary hospitals can improve the effective diagnosis and treatment rate, the quality of life, and other parameters, with good effectiveness and feasibility.
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Affiliation(s)
- Hua-Qin Shen
- Department of Pediatric Medicine, Affiliated Zhou Pu Hospital of the Shanghai Health Medical College, Shanghai, China
| | - Yan-Han Zhang
- Department of Pediatric Medicine, Affiliated Zhou Pu Hospital of the Shanghai Health Medical College, Shanghai, China
| | - Jing Zhang
- Department of Respiratory Medicine for Children, Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Qiu-Ming Sheng
- Department of Pediatric Medicine, Affiliated Zhou Pu Hospital of the Shanghai Health Medical College, Shanghai, China
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Kim YC, Song WJ. Neuro-Immune Interactions and IFN-γ in Post-Infectious Cough. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2022; 14:581-584. [DOI: 10.4168/aair.2022.14.6.581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 10/18/2022] [Accepted: 10/18/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Young-Chan Kim
- Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, Daejeon, Korea
| | - Woo-Jung Song
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Morice A, Dicpinigaitis P, McGarvey L, Birring SS. Chronic cough: new insights and future prospects. Eur Respir Rev 2021; 30:30/162/210127. [PMID: 34853095 PMCID: PMC9488126 DOI: 10.1183/16000617.0127-2021] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 08/20/2021] [Indexed: 11/25/2022] Open
Abstract
Chronic cough is defined in adults as a cough that lasts for ≥8 weeks. When it proves intractable to standard-of-care treatment, it can be referred to as refractory chronic cough (RCC). Chronic cough is now understood to be a condition of neural dysregulation. Chronic cough and RCC result in a serious, often unrecognized, disease burden, which forms the focus of the current review. The estimated global prevalence of chronic cough is 2–18%. Patients with chronic cough and RCC report many physical and psychological effects, which impair their quality of life. Chronic cough also has a significant economic burden for the patient and healthcare systems. RCC diagnosis and treatment are often delayed for many years as potential treatable triggers must be excluded first and a stepwise empirical therapeutic regimen is recommended. Evidence supporting most currently recommended treatments is limited. Many treatments do not address the underlying pathology, are used off-label, have limited efficacy and produce significant side-effects. There is therefore a significant unmet need for alternative therapies for RCC that target the underlying disease mechanisms. Early clinical data suggest that antagonists of the purinergic P2X3 receptor, an important mediator of RCC, are promising, though more evidence is needed. Chronic cough exerts a considerable burden on patients and healthcare systems. In addition to effective targeted therapies, further data are needed to understand the pathophysiology, epidemiology and disease burden.https://bit.ly/3Be9JZI
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Affiliation(s)
- Alyn Morice
- Centre for Clinical Sciences, Hull York Medical School, University of Hull, Hull, UK
| | - Peter Dicpinigaitis
- Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
| | - Lorcan McGarvey
- Centre for Experimental Medicine, Dentistry, and Biomedical Sciences, Queen's University, Belfast, UK
| | - Surinder S Birring
- Centre for Human & Applied Physiological Sciences, School of Basic & Medical Biosciences, Faculty of Life Sciences & Medicine, King's College Hospital, London, UK
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Lee JH, Kang SY, Yoo Y, An J, Park SY, Lee JH, Lee SE, Kim MH, Kanemitsu Y, Chang YS, Song WJ. Epidemiology of adult chronic cough: disease burden, regional issues, and recent findings. Asia Pac Allergy 2021; 11:e38. [PMID: 34786368 PMCID: PMC8563099 DOI: 10.5415/apallergy.2021.11.e38] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 12/12/2022] Open
Abstract
Chronic cough is a common medical condition that has a significant impact on patients' quality of life. Although it was previously considered a symptom of other disorders, it is now regarded as a pathologic state that is characterized by a deviation from the intrinsic protective functions of the cough reflex, especially in adults. There are several factors that may underlie the cough reflex hypersensitivity and its persistence, such as age, sex, comorbidities, viral infection, exposure to irritants or environmental pollutants, and their interactions may determine the epidemiology of chronic cough in different countries. With a deeper understanding of disease pathophysiology and advanced research methodology, there are more attempts to investigate cough epidemiology using a large cohort of healthcare population data. This is a narrative overview of recent findings on the disease burden, risk factors, Asia-Pacific issues, and longitudinal outcomes in adults with chronic cough. This paper also discusses the approaches utilizing routinely collected data in cough research.
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Affiliation(s)
- Ji-Hyang Lee
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung-Yoon Kang
- Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
| | - Youngsang Yoo
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Gangneung Asan Hospital, Gangneung, Korea
| | - Jin An
- Department of Allergy, Pulmonary and Critical Care Medicine, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Korea
| | - So-Young Park
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Ji-Ho Lee
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Seung-Eun Lee
- Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Min-Hye Kim
- Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Yoshihiro Kanemitsu
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
| | - Yoon-Seok Chang
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Woo-Jung Song
- Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Bai H, Sha B, Xu X, Yu L. Gender Difference in Chronic Cough: Are Women More Likely to Cough? Front Physiol 2021; 12:654797. [PMID: 34025449 PMCID: PMC8138462 DOI: 10.3389/fphys.2021.654797] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 04/14/2021] [Indexed: 11/15/2022] Open
Abstract
Chronic cough is a common complaint for patients to seek medical cares all over the world. Worldwide, about two thirds of chronic cough patients are females. However, in some regions of China the prevalence of chronic cough between sexes is roughly the same. Estrogen and progesterone can not only have an effect on transient receptor potential vanilloid 1 channel, eosinophils and mast cells, but also influence laryngeal dysfunction, gastroesophageal reflux disease and obstructive sleep apnea hypopnea syndrome, which may lead to increased cough sensitivity in women. On the other hand, the quality of life was adversely affected more in female patients with chronic cough. Both hormones possibly cause gender difference in chronic cough.
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Affiliation(s)
| | | | - Xianghuai Xu
- Department of Pulmonary and Critical Care Medicine, Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Li Yu
- Department of Pulmonary and Critical Care Medicine, Tongji Hospital, Tongji University School of Medicine, Shanghai, China
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Abstract
Cough is an important physiological mechanism to protect the lower airways, but it is also one of the most common symptoms that lead patients to seek medical consultations. Chronic cough, usually defined by cough duration longer than 8 weeks in adults, is prevalent in the community and impairs quality of life in individual patients. There are several characteristics that may differentiate pathologic coughs from protective cough responses, including cough duration, frequency, hypersensitivity, impaired cough suppressibility, or treatment refractoriness. However, the impact of cough, or its perceived severity, is a sum of the patient's experience of coughing and is a factor that may finally define cough as a disease. Social isolation is a major impact of chronic cough, which is now worse due to the coronavirus disease 2019 pandemic and a widespread fear of cough as a source of contagion. Emotional impact and economic impact (medical cost, reduced work productivity, and job loss) are also important complications of chronic cough, and they interact in a vicious cycle, aggravated by social isolation and treatment failures. This paper is a narrative review that aims to address the impact and disease burden of chronic cough in adult patients. We review the literature, but also introduce the findings from recent qualitative interviews and the patients' experiences of the impact and burden of chronic cough and discuss unmet needs in these patients.
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Affiliation(s)
- Ha-Kyeong Won
- Department of Internal Medicine, Veterans Health Service Medical Center, Seoul, Korea
| | - Woo-Jung Song
- Department of Allergy and Clinical Immunology, Airway Sensation and Cough Research Laboratory, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Health-Related Quality of Life and Related Factors in Persons with Preserved Ratio Impaired Spirometry: Data from the Korea National Health and Nutrition Examination Surve. ACTA ACUST UNITED AC 2020; 57:medicina57010004. [PMID: 33374629 PMCID: PMC7822493 DOI: 10.3390/medicina57010004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/16/2020] [Accepted: 12/20/2020] [Indexed: 01/04/2023]
Abstract
Background and Objectives: preserved ratio impaired spirometry (PRISm) is a common spirometric pattern that causes respiratory symptoms, systemic inflammation, and mortality. However, its impact on health-related quality of life (HRQOL) and its associated factors remain unclear. We aimed to identify these HRQOL-related factors and investigate the differences in HROOL between persons with PRISm and those with normal lung function. Materials and Methods: we reviewed the Korea National Health and Nutrition Examination Survey data from 2008 to 2013 to evaluate the HRQOL of persons with PRISm, as measured while using the Euro Quality of Life-5D (EQ-5D) and identify any influencing factors. PRISm was defined as pre-bronchodilator forced expiratory volume in 1 s (FEV1) <80% predicted and FEV1 to forced vital capacity (FVC) ratio (FEV1/FVC) ≥0.7. Individuals with FEV1 ≥80% predicted and FEV1/FVC ≥0.7 were considered as Controls. Results: of the 27,824 participants over the age of 40 years, 1875 had PRISm. The age- and sex-adjusted EQ-5D index was lower in the PRISm group than in the control group (PRISm, 0.930; control, 0.941; p = 0.005). The participants with PRISm showed a significantly higher prevalence of hypertension (p < 0.001), diabetes (p < 0.001), obesity (p < 0.001), low physical activity (p = 0.001), ever-smoker (p < 0.001), and low income (p = 0.034) than those in the control group. In participants with PRISm, lower EQ-5D index scores were independently associated with old age (p = 0.002), low income (p < 0.001), low education level (p < 0.001), and no economic activity (p < 0.001). Three out of five EQ-5D dimensions (mobility, self-care, and usual activity) indicated a higher proportion of dissatisfied participants in the PRISm group than the control group. Conclusions: the participants with PRISm were identified to have poor HRQOL when compared to those without PRISm. Old age and low socioeconomic status play important roles in HRQOL deterioration in patients with PRISm. By analyzing risk factors that are associated with poor HRQOL, early detection and intervention of PRISm can be done in order to preserve patients’ quality of life.
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Jin HJ, Kim CW. Understanding the Impact of Chronic Cough on the Quality of Life in the General Population. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2020; 12:906-909. [PMID: 32935485 PMCID: PMC7492517 DOI: 10.4168/aair.2020.12.6.906] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 08/08/2020] [Indexed: 01/04/2023]
Affiliation(s)
- Hyun Jung Jin
- Department of Internal Medicine, Medical School of Yeungnam University, Daegu, Korea
| | - Cheol Woo Kim
- Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea.
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Abstract
Chronic cough is a common condition, and generally affects about 3% of Korean adults with a significant influence on quality of life (QoL). Despite continued clinical and academic efforts, there are unmet needs for chronic cough prevention and management in Korea. Epidemiologically, there are two major challenges: an aging population and air pollution. Korea is one of the most rapidly aging countries, and the relative proportion of elderly to younger people is expected to double within the next two decades. Air pollution is a major concern, but there is very limited evidence on the effects of air pollutant on cough in Korean patients. Clinically, upper and lower airway diseases, such as rhinitis/rhinosinusitis and cough variant asthma/eosinophilic bronchitis, are reported to account for about 75% of chronic cough in Korean adults, which formed the basis in formulating clinical practice guidelines. However, further studies are warranted to resolve clinical uncertainty, particularly for the evaluation and treatment of upper airway conditions in chronic cough. The prevalence of gastroesophageal reflux disease (GERD) is increasing, thus its relevance to cough among Koreans may warrant re-evaluation. Infection-associated chronic cough, such as tuberculosis, is another continuing concern. The proportion of chronic refractory or unexplained cough is assumed to be 10–20% among patients visiting referral clinics for chronic cough. This review presents our perspectives on current epidemiological and clinical issues of chronic cough in Korea, and addresses major knowledge gaps and future research priorities.
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Affiliation(s)
- Ji-Hyang Lee
- Department of Allergy and Clinical Immunology, Airway Sensation and Cough Research Laboratory, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Woo-Jung Song
- Department of Allergy and Clinical Immunology, Airway Sensation and Cough Research Laboratory, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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