ORIGINAL ARTICLE
Chronic Cough From the Patient's Perspective

https://doi.org/10.4065/82.1.56Get rights and content

OBJECTIVE

To identify the factors that patients consider most concerning about their cough.

PATIENTS AND METHODS

All consecutive patients who presented with a complaint of chronic cough between November 1, 2000, and February 28, 2001, were prospectively surveyed for cough-related complaints using an 18-item symptom-complaint questionnaire. We analyzed frequencies of responses and response patterns to specific items on the questionnaire. We also examined whether the responses to individual items related to the patient's age, sex, and duration of cough.

RESULTS

Of the 146 consecutive patients referred for evaluation of chronic cough, 136 were eligible for inclusion in the study. These patients cited feelings of frustration, irritability, or anger (43%), frequent physician visits and testing (41%), and sleep disturbances (38%) as the most prevalent major problems. The responses to individual items on the questionnaire were not related to patients' age, sex, and cough duration. Anxiety about underlying serious illness continued to be a concern for most patients.

CONCLUSIONS

Frustration, anger, or anxiety was the most frequent major problem cited by patients. Frequent physician visits and testing was the unexpected second most frequent major problem. These findings are important because most chronic cough guidelines are based on clinical efficacy and cost-effectiveness considerations rather than on patient satisfaction. Future studies regarding chronic cough evaluation should take into account patient satisfaction and perceived burden of disease as outcome variables.

Section snippets

PATIENTS AND METHODS

All consecutive patients referred to the Mayo Clinic Division of Pulmonary and Critical Care Medicine outpatient clinic with a patient-provided complaint of chronic cough between November 1, 2000, and February 28, 2001, were prospectively surveyed for cough-related complaints. Patients were asked to participate in the survey with the objective of improving our understanding of their perceptions and needs regarding their cough problem. The questionnaire was handed to patients as they entered the

RESULTS

A total of 146 consecutive patients with a chief complaint of chronic cough were asked to participate, and 146 completed the cough-related adverse event survey in the 12-week study period. There were no nonresponders. Afterexcluding 10 patients because the requisite duration of cough could not be confirmed in 9 and was less than 3 weeks in 1, 136 patients were included in the analysis. Table 1 presents the demographic and clinical data of the patients included in the study. There were no

DISCUSSION

In this prospective study, we characterized areas of QOL impairment in patients with chronic cough evaluated at a tertiary care referral center. One of our most interesting findings was that interference with lifestyle and leisure; frequent physician visits; feelings of frustration, irritability, or anger; and sleep disturbances were identified most commonly by patients as major cough-related problems, surpassing anxiety about an underlying illness by a wide margin. This finding is in contrast

CONCLUSIONS

This study shows that patients referred for evaluation for chronic cough to a tertiary care center present with a high frequency of somatic and psychological complaints. Irritability, anger, frequent physician visits and testing, sleep disturbances, and interference with lifestyle and leisure are the most prevalent cough-related symptoms in this patient population. Patients are often concerned that their cough is a symptom of a serious underlying illness, whereas physicians often view cough as

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