Setting Priorities and Partnerships for Chronic Cough in Canada

Chronic cough is defined as a cough lasting >8 weeks and globally affects 10% of the population. Recent data from Canada has shown that the prevalence of chronic cough is 16%, which is the second highest in the world, and the number of new cases is increasing. Chronic cough increases with aging, peaks in the 50-60's, and is twice as more common in females than men. Chronic cough is also one of the commonest reasons for going to see a doctor and being referred to see a specialist. Patients with chronic cough often cough hundreds of times per day which leads to distressing physical, psychological and social consequences, especially in the post-COVID era. Patients with chronic cough are often treated for asthma, reflux disease of nasal disease but a large proportion have persistent coughing despite treating these conditions or there is no evidence of an underlying disease. We call this either refractory (RCC) or unexplained chronic cough (UCC). Unfortunately, there are no licensed treatment for this condition, so physicians will try pain killers such as opioids, anti-epilepsy drugs or anti-depressants but the evidence is very limited. These medications were not developed to treat chronic cough, and many patients cannot tolerate these medications because of side effects or risk of falls and addiction. We therefore badly need to understand why patients develop RCC/UCC, how best to investigate and manage in primary and secondary care and develop new treatments which are safe and effective. In this proposal, we have gathered a diverse group of healthcare professionals including physicians, nurses, physiotherapists, trainees and along with patients and professional organisations committed to education, awareness, and patient advocacy to conduct a 1 year priority setting exercise. This project will be the first to help to plan and disseminate the major priorities in research, education and training and guideline development in chronic cough.