Chronic cough in routine clinical practice: a UK retrospective cohort study

Abstract

Aims and Objectives: Chronic cough (CC) is a debilitating respiratory symptom, now increasingly recognized as a discrete disease entity. This study evaluated the burden of CC in a primary care setting. Methodology: This cross-sectional, retrospective cohort study used de-identified data from the Whole Systems Integrated Care (Discover) dataset, which includes >350 North West London (NWL) primary care practices, linking coded data from primary and secondary care. Data were extracted for individuals ≥18 years with a CC read code, cough (persisting ≥8 weeks) or cough remedy prescription (suppressant/expectorant/demulcent/mucolytic), between Jan 2015 - Sep 2019. The study was approved by the NWL Data Research Access Group. Results: Data extracted from 2,109,430 patients identified a cohort of 43,453 with CC. Median (IQR) age was 64 years (41-87), 22% were current and 22% previous smokers. Among the cohort, 26% had been given a diagnosis of asthma, 17% COPD, 12% rhinitis, 15% reflux, and 1% stress incontinence; 31% had no recorded comorbidities. Overall CC prevalence was 2%. Prevalence was greater in women (57%) than men (43%) and highest in the 65–74 age range (Figure). Conclusion: Data from routine clinical practice indicate 2% of the NWL adult population has CC and more women are affected than men. Appraisal of linked primary-care databases may enable earlier detection of CC patients, for specialist clinic referral and targeted treatment.