IMPACT OF CHRONIC COUGH ON QUALITY-OF-LIFE

Background: Cough is the most common complaint for which adult patient s seek medical care in the United States; however, the reason(s) for t his is unknown. Objectives: To determine whether chronic cough was ass ociated with adverse psychosocial or physical effects on the quality o f life and whether the elimination of chronic cough with specific ther apy improved these adverse effects. Methods: The study design was a pr ospective before-and-after intervention trial with patients serving as their own controls. Study subjects were a convenience sample of 39 co nsecutive and unselected adult patients referred for evaluation and ma nagement of a chronic, persistently troublesome cough. Baseline data w ere available for 39 patients and follow-up for 28 patients (22 women and 6 men). At baseline, demographic, Adverse Cough Outcome Survey (AC OS), and Sickness Impact Profile (SIP) data were collected and patient s were managed according to a validated, systematic protocol. Followin g specific therapy for cough, ACOS and SIP instruments were readminist ered. Results: The ages, sex, duration, and spectra and frequencies of the causes of cough were similar to multiple other studies. At baseli ne, patients reported a mean +/- SD of 8.6 +/- 4.8 types of adverse oc currences related to cough. There were significant correlations betwee n multiple ACOS items and total, physical, and psychosocial SIP scores . Psychosocial score correlated with total number of symptoms (P<.02). After cough disappeared th treatment, ACOS complaints decreased to a mean +/- SD of 1.9 +/- 3.2 (P<.0001) as did total (mean +/- SD, 4.8 +/ - 4.5 to 1.8 +/- 2.2) (P =.004),psychosocial (mean +/- SD, 4.2 +/- 6.8 to 0.8 +/- 2.3) (P =.004),and physical (mean +/- SD, 2.2 +/- 2.9 to 0 .9 +/- 1.8) (P =.05) SIP scores. Multiple linear regression analysis s howed that 54% of variability of the psychosocial SIP score was explai ned by 4 ACOS items while none of the physical score was explained. Co nclusions: Chronic cough was associated with deterioration in patients ' quality of life. The health-related dysfunction was most likely psyc hosocial. The ACOS and SIP appear to be valid tools in assessing the i mpact of chronic cough.