Jeannette Y. Wick, RPh, MBA, FASCP
Cough is the most aggravating late-stage cold symptom.
The ACHOO study found cold-associated cough reduces quality of life and promotes absenteeism. Higher brain regions can voluntarily suppress brainstem-mediated urge to cough. Cough intensity and quantity is associated with increased urge.
Why and how cough develops during a cold is unclear. Postnasal drip is the most likely driver of cough early in the course of a cold. Increased airway reactivity or lower airway infection (eg, excess mucus in the lungs) may cause late-stage common cold-induced cough.
A team of researchers found cough sufferers are bothered by urge to cough but usually do not seek medical treatment or advice in a new study published in May 2016 by the journal Postgraduate Medicine.
Grail Research and PfizerWorks asked men and women 18 years and older who had a cold with cough within the past 3 months to fill out a 51-question online survey. The researchers excluded participants with recurrent cough, asthma, chronic bronchitis, chronic obstructive pulmonary disease, cystic fibrosis, or gastrointestinal reflux disease.
The most commonly reported cold symptoms were cough, fatigue, excess mucus, runny nose, and nasal congestion in decreasing order. These findings align with the retrospective ACHOO study, but a prospective study found that nasal and throat symptoms are more common. Recall bias may explain the different findings and the ACHOO study’s results toward a greater focus on late-stage symptoms.
Two-thirds of participants noted having the urge to cough, and the majority believed the urge to be at least as bothersome as the coughing itself. Less than 20% of respondents sought medical advice, and providers chiefly recommended prescription options.
Cough was exacerbated by changing posture, especially lying down, and it worsened at night, which impacted sleep quantity and quality.
Only 23% of participants described their cough as “wet” or “productive,” but 89% reported mucus with their cough. This highlights the importance of properly worded survey questions and patient inquiries.
An important point for clinicians is that patients are often reluctant to seek medical advice about urge to cough, despite being unable to control the urge.