Women are more sensitive to cough triggers, have greater cough frequencies, and experience more cough-associated symptoms yet previous reports have been unable to consistently demonstrate that chronic cough has a greater impact on quality of life (QOL) in women. The inability to consistently show gender-related differences in QOL may be explained by previous studies being underpowered, particularly the relatively small number of men.
Patients referred to a chronic cough clinic completed the University of Massachusetts cough-specific QOL questionnaire (CQLQ). They also completed a 0–10 visual analog scale (VAS) to score the severity of cough-associated symptoms. The CQLQ and VAS results were analyzed by gender.
Data was available from 379 patients including 129 men, 50.8 +/− 14.1 years, BMI 28.4 +/− 6.0, FEV1% predicted 98.5 +/− 16.2, and median cough duration of 21 months (mean duration 73 +/− 107 months). The total CQLQ score was greater in women (61.7 +/− 14.5 versus 52.9 +/− 12.8, p < 0.001). In health status studies, if the quotient of the difference divided by the standard deviation, the effect size, is greater than 0.5, it is considered clinically important. In this study the effect size is greater than 0.6, suggesting that it is clinically relevant. Higher CQLQ scores represent a worse QOL. In women, CQLQ scores in the physical (20.1 +/− 5.7 vs 17.3 +/− 5.2, p < 0.0001), psychosocial (12.9 +/− 3.7 vs 11.0 +/− 3.4, p > 0.0001), functional (10.4 +/− 3.9 vs 8.8 +/− 3.1, p < 0.0001), emotional (6.0 +/− 1.9 vs 5.4 +/− 1.6, p < 0.004), and extreme physical (8.2 +/− 2.7 vs 6.3 +/− 1.9, p < 0.0001) domains were rated poorer than in men. The personal safety domain scores were similar in men and women (7.4 +/− 2.3 vs 7.2 +/− 2.1, p = 0.39).
Cough has a greater impact on QOL in women, effecting the functional and emotional domains in addition to the previously reported effects on the physical and psychosocial domains.
Women are more likely to seek medical attention for chronic cough. Understanding the gender-related differences in chronic cough and its complications is important to properly evaluate, treat and support these patients. These differences should be considered in the design of future chronic cough studies.
Stephen Field, No Financial Disclosure Information; No Product/Research Disclosure Information