Cough Working Group ERS 2017

1. COUGH WORKING GROUP
MEETING
CHAIR: Lorcan McGarvey
DATE: Sunday 10th September 2017
TIME: 08:00-09:00
VENUE: Melia Milano Hotel, Via Masaccio 19, Milan, Italy

2. Agenda
• 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.

3. Chronic cough over the last 25 years
• Significant progress
• Diagnostic management protocols developed and refined – ACCP /
ERS Taskforce
• Improved mechanistic understanding – cough hypersensitivity
• Clinical trials – P2X3 antagonist, gabapentin, Speech & Language
therapy
• Establishing Networks and Consortia
• Largely confined to secondary care/specialist cough clinics

4. 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
and treatment…..’

5. 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.

6. Study methodology
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
disease.
o Electronic medical records are complemented by patient reported
data.
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.

7. Read Codes - Include

8. Read Codes - Exclude

9. Read Codes – Productive cough

10. Considerations for Cough Working
Group
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
period
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
phenotypes?
• Female gender?
• Chronic Cough associated with respiratory disease asthma/COPD/IPF/ Lung cancer
etc.
• Association with non-respiratory disease – auto-immune disease – thyroid disorders
• Look at factors that predict development of chronic cough?
• Economics – health care utilisation
• Mortality?

11. Discussion