The Sensations and Triggers of Coughing in Refractory/Uexplained Chronic Cough

<bold>Background:</bold> Refractory and Unexplained Chronic Cough (R/UCC) are presentations frequently associated with cough hypersensitivity syndrome (CHS). The TOPIC-15 questionnaire (TOPICQ-15) has been developed to evaluate sensations and triggers often described in R/UCC and to assess if they improve with standard treatments as part of the StaRR study. <bold>Aims:</bold> To present preliminary baseline characteristics, patient reported outcome measures (PROMs) and objective cough counts in an undifferentiated cohort of new patient referrals to a tertiary cough clinic. <bold>Methods:</bold> 48 new patient referrals to the Manchester Cough Clinic underwent baseline VAS, Verbal cough severity, LCQ, TOPICQ-15 and 24-hour ambulatory cough monitoring. <bold>Results:</bold> Median age (IQR) 61 years (50.75–68.25), 68.8% (33) female. 43.8% (21) patients had RCC and 75% (36) had features of CHS. Median cough duration was 7 years (3.6–11.3). Median TOPICQ-15 Score was 31 (25-51). Baseline LCQ was 11.3 (9.2–16.4), day VAS 62 (26–75), and night VAS 34 (3–64). Median (IQR) 24-hour count was 14.29/hr (7.1-27.0), awake cough frequency 22.74/hr (11.1-32.2) and sleep cough frequency 1.16/hour (0.4-3.4). Awake cough frequency did not correlate with day VAS (p=0.313), LCQ (p=0.303) or TOPIC-15 score (p=0.508). TOPIC-15 negatively correlated with LCQ score (r=-0.591, p<0.01). <bold>Conclusion:</bold> Patients with chronic cough undergo years of unrelenting symptoms before referral to specialist cough clinics for diagnosis and management. They often report unpleasant somatic sensations and multiple cough triggers associated with a worse Quality of Life (QoL).