COUGH WORKING GROUP
CHAIR: Lorcan McGarvey
DATE: Sunday 10th September 2017
VENUE: Melia Milano Hotel, Via Masaccio 19, Milan, Italy
• Welcome and Introductions
• Background to REG activity
• Objectives of the Cough Working Group
• Discussion of the study protocol
Background, Aims & Methods
Review and discussion of Read Codes for cough
Agreement on how we define ‘Chronic cough’
• Other research needs and ideas to address them.
Chronic cough over the last 25 years
• Significant progress
• Diagnostic management protocols developed and refined – ACCP /
• Improved mechanistic understanding – cough hypersensitivity
• Clinical trials – P2X3 antagonist, gabapentin, Speech & Language
• Establishing Networks and Consortia
• Largely confined to secondary care/specialist cough clinics
Objectives of the Cough Working Group
‘……working together to identify and fulfil the real-
life research needs in COUGH, advancing
knowledge to drive improved patient management
Identifying clinical characteristics and
variables associated with a diagnosis of cough
in UK general practice
• Objectives - Provide 'real life' data on the clinical pattern
and health burden of chronic cough in primary care where
most patients are managed
• to determine the epidemiological pattern and clinical
characteristics of chronic cough.
Utilise the Optimum Patient Care Research Database (OPCRD)
o Longitudinal, primary care database comprising ~2.5 million patients
from over 550 UK general practices.
o Anonymised research quality data with a focus on respiratory
o Electronic medical records are complemented by patient reported
o Data source for >50 publications in the last 5 yrs.
Retrospective, observational database study of OPCRD individuals with a Read
Code algorithm compatible with a diagnosis of chronic cough.
Individuals matched with up to 4 control individuals, who have database entries
in same calendar year but do not meet criteria for chronic cough, using gender,
5- year age band, practices.
Considerations for Cough Working
What are the appropriate Read Codes for chronic cough?
How will we define ‘Chronic cough’?
e.g. ?2 episodes (any read code for cough) ≥ 8 weeks apart in preceding 6/12 month
What do we want to know?
• Descriptive statistics- Incidence and prevalence of chronic cough in UK general
practice – opportunity to extend
• What does chronic cough look like in the general population/primary care – distinct
• Female gender?
• Chronic Cough associated with respiratory disease asthma/COPD/IPF/ Lung cancer
• Association with non-respiratory disease – auto-immune disease – thyroid disorders
• Look at factors that predict development of chronic cough?
• Economics – health care utilisation