Adverse perception of cough in patients with severe asthma: a discrete choice experiment

Abstract

BackgroundAsthma symptoms adversely impact quality of life in particular in those with poor disease control. Commonly used patient reported measures for asthma used to assess asthma control often inadequately capture the impact of cough, despite evidence that cough is one of the most bothersome symptoms for patients with asthma. This study aims to improve our understanding of how patients with asthma perceive cough to better understand its clinical impact.MethodsA discrete choice experiment (DCE) was performed in two distinct adult asthma populations; those with severe asthma as defined by GINA step 4/5 classification and those with moderate asthma (a GINA steps 2 or 3 classification of asthma severity).ResultsChoices were highly dominated by the cough attribute in the symptoms complexes; 48.4% of patients with severe asthma and 31.3% with moderate asthma consistently chose the alternative with the lowest level of cough. Furthermore, cough predominance was found to be significantly associated with severity of asthma (p=0.047). Patients with moderate asthma were not willing to accept any additional symptoms to reduce cough from severe to mild. However, these patients were willing to accept mild breathlessness, mild sleep disturbance, severe chest tightness and severe wheezing to remove coughing altogether.ConclusionsPatients with asthma prefer to have less cough and are willing to accept greater levels of other symptoms to achieve this. Additionally, asthma severity may influence an individual's perception of their symptoms; cough is a more important symptom for patients with severe asthma than those with a milder disease.

Bronchial Asthma and COVID-19: Etiology, Pathological Triggers, and Therapeutic Considerations

“…However, until now there is no clear idea of whether asthma progresses during or after COVID-19 infection. According to the results of some studies, a significant difference was identified between the development of bronchial asthma in people after COVID-19 [ 123 ]. Several factors explain this difference, including different vulnerability to COVID-19 infection and differences in asthma prevalence among different races or ethnic groups [ 124 ].…”

“…According to analysis data, people with asthma are at lower risk of COVID-19 infection compared with people without asthma, but have the same risk of hospitalizations, ICU admissions, ventilator use, and mortality for positive reverse transcription polymerase chain reaction (RT-PCR) [ 123 ].…”

“…Some studies have suggested that there is a large difference between the number of COVID-19 infections in patients with asthma in different geographic regions [ 123 ]. Several factors explain these differences: different reactivity to COVID-19 infection and differences in asthma prevalence among different races or ethnic groups [ 124 ].…”

Interaction effect of chronic cough and ageing on increased risk of exacerbation in patients with asthma: a prospective cohort study in a real-world setting

“…Cough is the most troublesome symptom for patients with asthma [ 6 , 7 ]. The worldwide prevalence of chronic cough (CC) is approximately 10%, with up to 6% in the Chinese population aged ≥50 years, resulting in impaired quality of life [ 8 , 9 ].…”

Severe asthma patients’ and physicians’ perspectives of disease burden: do they match?

“…It is important to emphasise that an improved study design including PROs could ensure that high-quality data inform patient-centred care. For instance, H olmes et al [ 14 ] have shown that coughing, which is included in the theme “direct physical symptoms of asthma” in the study by A insworth et al . [ 5 ], is the most bothersome symptom for asthma patients.…”