Chest
Volume 134, Issue 2, August 2008, Pages 295-302
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Original Research
Cough
Impact of Cough Across Different Chronic Respiratory Diseases: Comparison of Two Cough-Specific Health-Related Quality of Life Questionnaires

https://doi.org/10.1378/chest.07-0141Get rights and content

Background

Cough is a prominent symptom across a range of common chronic respiratory diseases and impacts considerably on patient health status.

Methods

We undertook a cross-sectional comparison of scores from two cough-specific health-related quality of life (HRQoL) questionnaires, the Leicester Cough Questionnaire (LCQ), and the Cough Quality of Life Questionnaire (CQLQ), together with a generic HRQoL measure, the EuroQol. Questionnaires were administered to and spirometry performed on 147 outpatients with chronic cough (n = 83), COPD (n = 18), asthma (n = 20), and bronchiectasis (n = 26).

Results

There was no significant difference in the LCQ and CQLQ total scores between groups (p = 0.24 and p = 0.26, respectively). Exploratory analyses of questionnaire subdomains revealed differences in psychosocial issues and functional impairment between the four groups (p = 0.01 and p = 0.05, respectively). CQLQ scores indicated that chronic coughers have more psychosocial issues than patients with bronchiectasis (p = 0.03) but less functional impairment than COPD patients (p = 0.04). There was a significant difference in generic health status across the four disease groups (p = 0.04), with poorest health status in COPD patients. A significant inverse correlation was observed between CQLQ and LCQ in each disease group (chronic cough r = − 0.56, p < 0.001; COPD r = − 0.49, p = 0.04; asthma r = − 0.94, p < 0.001; and bronchiectasis r = − 0.88, p < 0.001). There was no correlation between cough questionnaire scores and FEV1 in any group, although a significant correlation between EuroQol visual analog scale component and FEV1 (r = 0.639, p = 0.004) was observed in COPD patients.

Conclusion

Cough adversely affects health status across a range of common respiratory diseases. The LCQ and CQLQ can each provide important additional information concerning the impact of cough.

Section snippets

Study Population

The study was conducted over a 1-year period between August 2003 and August 2004. Consecutive unselected patients with chronic cough referred to a Specialist Cough Clinic at the Belfast City Hospital were recruited together with patients with clinically stable asthma, COPD, or bronchiectasis attending general respiratory outpatient review clinics. The latter three patient groups were recruited consecutively and not because they reported cough as a prominent or troublesome symptom. All cough

Results

Table 1 contains baseline characteristics of the 147 patients recruited to the four groups as well as test statistics for comparisons of these characteristics between the groups. Diagnostic categories in the chronic cough group were as follows: gastroesophageal reflux, 35%; asthma, 21%; idiopathic cough, 12%; postnasal drip, 7%; postviral, 6%; eosinophilic bronchitis, 6%; and other, 13% (eg, angiotensin-converting enzyme inhibitor-related cough, pulmonary fibrosis). There was a significant

Discussion

This is the first study to compare the impact of cough on HRQoL across a range of common chronic respiratory diseases using validated cough-specific quality of life questionnaires. We have demonstrated that the magnitude of cough-specific HRQoL impairment is similar among all respiratory disease groups studied and is greatest among female patients. Generic measures of HRQoL in COPD patients were significantly lower than chronic cough, asthma, and bronchiectasis patients, and this appeared to be

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    The authors have no conflicts of interest to disclose.

    Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).

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