Cough Severity Visual Analogue Scale Research Articles

The prevalence of cough in lung cancer: Its characteristics and predictors.

162 Background: Cough commonly affects patients with LC but quoted prevalence figures vary and most were obtained before advances in anticancer treatment for LC. This study aimed to determine its prevalence and characteristics (severity, impact and potential predictors) in patients undergoing standard treatment and follow up. Methods: Consecutive LC patients attending clinics at The Christie Hospital, UK during a predefined 5 week period were asked whether they had a cough and invited to participate in its further evaluation according to an ethically approved protocol. Demographic, cancer and cancer treatment data were collected in all. Patients with a cough also completed subjective assessments using the validated cough impact Manchester cough in LC scale (MCLCS) and cough severity visual analogue scale (VAS). Standard statistical tests were used for analysis with significance (p<0.05). Results: Of 223 consecutive LC outpatients approached, the prevalence of cough was 57% (128/223); 202/223 (86%) consented to further data collection (study population) and of these 115 (57%) reported cough. The majority (60/115, 52%) felt that their cough warranted treatment and 23% reported their cough to be painful (26/115). The median VAS score (n=115) was 32mm (25th-75th IQR 20-51, range 0-100, high scores = worse cough severity). The median MCLCS score (n=113) was 22 (25th-75th IQR 16-27, range 1-50, high scores = worse cough impact). There was no significant difference between coughers and non-coughers with respect to age, sex, co-morbidities, smoking, performance status, treatment intent, treatment type, reasons for not receiving treatment, stage and histology. The proportion of non-coughers was lower among patients receiving anticancer therapy (45/115 39% vs 47/87 54%, p=0.04) in univariate analysis. Conclusions: Cough is present in the majority of LC patients, even in those undergoing treatment. Many patients feel that it warrants treatment. Whilst many consider factors such smoking, stage, histology and cancer treatment type to be important determinants of the presence of cough, our data does not reflect this. Improving LC related cough requires more than better cancer therapies.

P58 The Characterisation and Subjective Assessment of Cough in Lung Cancer and Mesothelioma: The “CLAIM” Study

Introduction Lung cancer (LC) and mesothelioma (M) are usually terminal, with poor 5-year survival. Therefore, symptom control is crucial. Cough is a significant problem with physical, psychological and social consequences. It has a broad aetiology and its physiological mechanisms remain unclear. Methods for its assessment are unreliable and available treatments are limited; the absence of valid quantification of cough prevalence and impact hinders the development of novel therapies. CLAIM evaluates the impact and prevalence of cough in LC and M using validated assessment tools. Methods Consecutive outpatients attending two cancer centres over a 5 week period completed the Manchester Cough in Lung Cancer Scale (MCLCS) and a cough severity visual analogue scale (VAS). Demographic and clinical data were collected. Results Patients were of advanced age (LC mean 66years, M mean 71years), predominately male (LC 54.9%, M 75.0%), with advanced disease (advanced non-small-cell LC 80.5%, extensive small-cell LC 71.4%). Those on treatment largely received palliative treatment (LC 89.7%, M 100%). The majority of patients were performance status ≥2 (LC 51.7%, M 60%). Cough was reported by 58% of LC patients (n = 224) and 43% of M patients (n = 60); painful cough was reported by 23% and 18%, respectively. LC and M patients felt their cough warranted treatment in 53% and 40% of cases. Cough was associated with breathlessness (LC 61.9%, M 63.6%), disrupted sleep (LC 47.8%, M 52.4%) and interrupted conversations (LC 64.6%, M 59.1%). There were moderate-strong correlations between MCLCS and VAS scores in all patient groups [non-small-cell (r = 0.68), small-cell LC (r = 0.66) and mesothelioma (r = 0.71), all p Conclusions This is the first study comparing the prevalence and impact of cough in LC and M using validated cough-specific assessment tools, in a clinically representative population. Cough is common in these cancers and has marked effects on quality of life. In the absence of evidence-based treatments, it represents an unmet clinical need. The high prevalence of cough in M is counterintuitive, in view of the tumour location. The MCLCS and VAS correlations suggest these are complementary tools which perform reliably in these disease groups.

P59 The Characterisation of Cough in Lung Cancer

IntroductionCough in lung cancer (LC) is a distressing symptom with a significant impact on quality of life (QoL), and no effective therapies. Little data is available defining the proportion of...

S144 Acute cough: a longitudinal observational study

IntroductionAcute cough is a common illness with more than 12 million episodes each year in the UK. More than £100 million is spent on over-the-counter cough medicines annually, despite limited...

S140 Predictors of 24-h cough frequency in acute cough

Introduction24-hour cough frequency monitoring is increasingly being used as an outcome measure to evaluate anti-tussive drugs. The optimal method of identifying patients with a significant cough frequency for inclusion into...