Understanding health utilisation of refractory chronic cough
Research type
Research Study
Full title
To understand the costed care pathway and subsequent healthcare resource utilisation in patients diagnosed with Refractory Chronic Cough (RCC) compared to an age, sex match cohort
IRAS ID
256294
Contact name
Jaclyn Smith
Contact email
Sponsor organisation
Merck Sharp & Dohme Corp., a subsidiary of Merck & Co
Research summary
Summary of Research
The aim of this study is to see how participants are diagnosed with refractory chronic cough. We want to see that, once a diagnosis of refractory chronic cough has been made, does any treatment for the cough, or simply knowing why you are coughing, change the number of times you need to see your GP or be seen at hospital.
Summary of Results
Thank you to study participants.
As a study participant, you belong to a large community of participants around the world. You help researchers answer important health questions and help them discover new medical treatments.
The sponsor (researcher) and study team think it is important for you to know the results of the study you took part in, to help you understand and feel proud of your key role in medical research.
If you have questions about the results, please speak with the doctor or staff at your study site.Here we will describe the results of this study.
The study title.
An observational study, to understand the costed care in patients diagnosed with Refractory Chronic Cough (RCC) or Unexplained Chronic Cough (UCC).Who carried out the research?
The study was run by Professor Jaclyn Smith. Professor Smith runs the cough clinic that you have attended at Wythenshawe or Withington Hospital.
The study was sponsored by a pharmaceutical company called Merck Sharp & Dohme Ltd (MSD).
The study was supported by Northwest EHealth (NWEH), who specialise in gathering and analysing study data.
Where and when the study took place
The study started on 30th July 2019 and ended on 25th October 2021 and took place across the Northwest of England.Why was the study done?
This study was carried out to gain more information on how people are diagnosed with, and treated for, chronic cough. It will help patients, researchers, and the pharmaceutical companies who are developing drugs, to better understand the costs and patient experiences related to chronic cough.What were the main questions studied?
The aim of this study was to understand how many times patients are seen by health care professionals and how many diagnostic tests are performed before getting a diagnosis of refractory or unexplained chronic cough at Professor Smith’s clinic.How many patients joined the study?
200 patients with a diagnosis of refractory or unexplained chronic cough were enrolled into the study after returning a signed consent form.
In addition, the study had a control group of 1000 patients who were enrolled from Professor Smith’s clinic. Data of the control group were extracted from the Salford Integrated Record Research Database which contains a pool of anonymised patient data. Patients in the control group did not have a diagnosis of refractory or unexplained chronic cough and had similar demographic information as the consented patients from Professor Smith’s clinic, such as sex, age, and smoking status.What happened during the study?
Patients’ data was collected in two ways:
1. Review of electronic patient records: information was collected from the patients’ General Practitioner (GP) and hospital, using their electronic medical record, to identify what investigations, treatments, and medications they may have had in the five years before, and the two years after, they were diagnosed as having a chronic cough. Other information collected included other health problems and how many times patients had visited their GP or other Health Professional.
2. Review of hospital paper records: information was collected from cough clinic records; medical records which included data about the nature, severity, investigations, and treatments used to treat chronic cough.What were the results of the study?
The study found that in the 5 years leading up to a diagnosis of refractory or unexplained chronic cough patients were seen more times by healthcare professionals, had more medications prescribed, and attended more outpatient and day-case hospital visits when compared to those patients in the control group. These results show that there is a big cost implication to the NHS over the 5 years leading up to a diagnosis of refractory or unexplained chronic cough.
The study also showed that in the 6 months after a diagnosis of refractory or unexplained chronic cough, costs to the NHS were higher because of the further specialist investigations needed by Professor Smith’s clinic, but, after this, the costs started to fall back down to lower levels than before the diagnosis.
The study concluded that patients suffering with refractory or unexplained chronic cough have a long and drawn-out journey through the healthcare system before they get a diagnosis, which could delay them getting the best treatment and is a big cost to the NHS.How has this study helped patients and researchers?
This study helped researchers better understand the costs and patient experiences related to refractory chronic cough and may inform future development and improvement of disease management.Where can I learn more about this study?
If you have questions about the study, please contact the study team at
0161 519 8989 Monday to Friday between the hours of 9am and 5pm.REC name
South Central - Hampshire A Research Ethics Committee
REC reference
19/SC/0180
Date of REC Opinion
12 Apr 2019
REC opinion
Favourable Opinion