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)
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.  

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