Qualitative assessment of sensations and triggers in chronic cough

Abstract

Chronic cough (CC, lasting ≥8 weeks) affects around 10% of the global population and has a substantial impact on patients’ quality of life [1]. CC which persists despite extensive investigation and treatment trials is termed refractory (RCC). Expert consensus is that RCC is largely driven by cough reflex hypersensitivity (CRH), considered to be of neurological pathology [2–4]. Evidence for neural pathophysiology in CC includes the presence of hyperinnervation of airway nerves [5], decreased activation of cough suppression centres in functional MRI studies [6], and benefit to cough from neuromodulator medication [7–9]. Objectively, CRH is identified by tussive challenge testing with stimuli such as capsaicin, ATP, and citric acid [10]. Furthermore, key CRH features are akin to triggers and sensations of neuropathic pain, namely allotussia, hypertussia, and laryngeal paraesthesia [11]. There is a paucity of studies that has investigated triggers and sensations in CC. Of these, no study has used qualitative methodology to elucidate the range of potential triggers and sensations. The aim of this study was to qualitatively assess CC triggers and sensations, utilising open-ended concept elicitation in semi-structured interviews. Footnotes This manuscript has recently been accepted for publication in the ERJ Open Research . It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article. Conflicts of Interest: SB, BH, PC, KR, HK declare no conflicts of interest in relation to this manuscript.

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