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Burden of Disease Associated with Refractory and Unexplained Chronic Cough in Canada: Results from a National Survey

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Abstract

Introduction

Chronic cough (persisting for ≥ 8 weeks) is a common disorder that includes refractory chronic cough (RCC; cough that persists despite treatment of underlying disease) and unexplained chronic cough (UCC; cough with no identifiable cause). We evaluated self-reported health-related quality of life (HR-QoL) and work/activity impairment associated with RCC/UCC in Canada.

Methods

Our exploratory study included Canadians in the Leger Opinion Panel with RCC or UCC. Key entry criteria were ≥ 18 years of age, cough for ≥ 8 weeks, not currently smoking/quit ≥ 1 year ago, no serious respiratory disease or lung cancer, and not taking angiotensin-converting enzyme inhibitors. Respondents completed a 30-min online survey with general and cough-specific HR-QoL questionnaires, including the EuroQol (EQ) visual analogue scale (VAS), EQ-5-dimension 5-level (EQ-5D-5L), cough severity VAS, Leicester Cough Questionnaire (LCQ), and Work Productivity and Activity Impairment-Specific Health Problem (WPAI-SPH).

Results

Of 49,076 individuals who completed the chronic cough screening questionnaire (July 30-September 1, 2021), 1,620 (3.3%) met entry criteria for RCC/UCC and 1,046 (2.1%) completed the survey. The mean age of respondents was 45 years and 61% were female. Respondents reported impairments in global HR-QoL (EQ-VAS 73.8, 61% with anxiety/depression on the EQ-5D-5L) and cough-specific HR-QoL (mean cough severity VAS score 29.7, LCQ index 15.2). Work and non-work activities were reduced by 34% and 30%, respectively, on the WPAI-SPH.

Conclusion

RCC/UCC is prevalent in Canada and associated with impaired HR-QoL, particularly in mental health domains. Additional support and management options may be required to fully address this burden.

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Data Availability

The data sharing policy, including restrictions, of Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Rahway, NJ, USA is available at http://engagezone.msd.com/ds_documentation.php. Requests for access to the clinical study data can be submitted through the Engage Zone site or via email to dataaccess@merck.com.

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Acknowledgements

The authors of the study would like to thank the individuals who participated in this survey. We also thank Sharon L. Cross, PhD (Fusion MD Medical Science Network, Inc., Montreal, Canada), for providing manuscript support with funding from Merck Canada Inc., Kirkland, QC, Canada and Leger Opinion Panel for conducting the survey.

Funding

The study and medical writing support was funded by Merck Canada Inc., Kirkland, QC, Canada.

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Authors and Affiliations

  1. Department of Medicine, McMaster University Medical Centre, 3U9, 1280 Main St. West, Hamilton, ON, L8S 4L8, Canada

    Danica Brister, Sana Khan & Imran Satia

  2. Firestone Institute for Respiratory Health, St. Joseph’s Healthcare, Hamilton, ON, Canada

    Sana Khan & Imran Satia

  3. Merck Canada Inc., Kirkland, QC, Canada

    Ted Abraham, Samuel Laventure & Sevag Sahakian

  4. Medical Department, MSD, Madrid, Spain

    Berta Juliá

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  1. Danica Brister
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Contributions

Conceptualization: Danica Brister, Sana Khan, Samuel Laventure, Ted Abraham, Sevag Sahakian, Berta Juliá, Imran Satia. Data curation: Samuel Laventure, Ted Abraham, Sevag Sahakian, Berta Juliá. Formal analysis: Samuel Laventure, Ted Abraham, Sevag Sahakian, Berta Juliá. Funding acquisition: Ted Abraham, Sevag Sahakian. Investigation: Samuel Laventure, Ted Abraham, Sevag Sahakian, Berta Juliá. Methodology: Samuel Laventure, Ted Abraham, Sevag Sahakian, Berta Juliá. Project administration: Ted Abraham, Sevag Sahakian, Berta Juliá. Resources: Samuel Laventure, Ted Abraham, Sevag Sahakian, Berta Juliá. Supervision: Ted Abraham, Sevag Sahakian, Berta Juliá. Visualization: Samuel Laventure, Ted Abraham, Sevag Sahakian, Berta Juliá. Writing – original draft: Danica Brister, Sana Khan, Ted Abraham, Imran Satia. Writing – review & editing: Danica Brister, Sana Khan, Samuel Laventure, Ted Abraham, Sevag Sahakian, Berta Juliá, Imran Satia.

Corresponding author

Correspondence to Imran Satia.

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Competing Interests

DB is supported by McMaster University and reports grants from the University of Calgary. SK has no conflicts of interest.SL, TA, and SS are employees of Merck Canada Inc., Kirkland, QC, Canada, the study sponsor. BJ is an employee of MSD Spain. IS is currently supported by the E.J. Moran Campbell Early Career Award, McMaster University and reports grants from ERS Respire 3 Marie Curie fellowship, Merck, GSK and MITACS and speaker and/or consulting fees from Merck, GSK, AstraZeneca, Roche, Genentech and Respiplus.

Ethical Approval

The study protocol and questionnaire were reviewed and approved by the Veritas Independent Review Board prior to study initiation (May 18, 2021; tracking number 2021–2691-6128–3).

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Informed consent was obtained electronically from all respondents prior to study participation.

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Brister, D., Khan, S., Abraham, T. et al. Burden of Disease Associated with Refractory and Unexplained Chronic Cough in Canada: Results from a National Survey. Lung (2024). https://doi.org/10.1007/s00408-024-00714-1

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