P179 Patient perspective of diagnosis and treatment of chronic cough: a descriptive analysis of UK adults

Introduction The patient perspective of chronic cough (CC) diagnosis and treatment path is not well-documented. Aim To describe patient-reported diagnosis and treatment patterns among UK adults with CC. Methods An ethics-approved CC survey was administered to 2018 National Health and Wellness Survey respondents who reported coughing daily for ≥8 weeks. CC survey respondents had active CC and were excluded if they smoked/vaped in the past year or were prescribed oral corticosteroids or ACE inhibitors. Results There were 112 CC respondents (mean age 58.1 years; 65% female; mean CC duration 5.6 years). Of the 77% who sought evaluation for their CC from a healthcare provider (HCP), most were evaluated (93%) and treated (88%) in primary care while 48% were evaluated and 14% were treated by a specialist. The most common diagnostic tests recalled were chest imaging (60% of respondents) and breathing tests (58%). Three-fourths (77%) of the respondents had any recall of a doctor attributing their CC to one or more of the common phenotypes of CC. Where this was the case, asthma (34%), gastro-oesophageal reflux (27%) and upper airways disease (post-nasal drip 19%; nasal allergies 14%; allergic rhinitis 13%) were most common. Of the 61% given medical treatment for their CC, the most frequently prescribed were nasal steroids (32%), inhaled steroids (29%) and first-generation antihistamines (29%). These medications provided ‘a great deal’ of CC relief for 15% or fewer respondents, depending on Rx class. CC respondents often purchased OTC medication (49%) or tried home remedies (38%) to treat their CC. Although 61% of respondents believed their HCP was ‘somewhat’ or ‘extremely knowledgeable’ in evaluating and treating CC, 47% felt their HCP did not understand the impact of CC on their life, 57% felt they were not referred to enough or the right specialists and 81% felt not enough tests were ordered. Forty-seven percent (47%) of respondents stopped seeking medical care due to lack of success treating CC. Conclusions Although UK adults suffering from CC are often evaluated in primary and secondary care, the majority remain unresolved and many felt more could be done to help them find relief.