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

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.

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

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…..’

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.

Study methodology Utilise the Optimum Patient Care Research Database (OPCRD) Longitudinal, primary care database comprising ~2.5 million patients from over 550 UK general practices. Anonymised research quality data with a focus on respiratory disease. Electronic medical records are complemented by patient reported data. 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.  

Read Codes - Include

Read Codes - Exclude

Read Codes – Productive cough

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?

Discussion