Persistent Cough: Changes in Prevalence, Impact, and Beliefs From 2006–2015 in Italy

Background: Persistent cough is one of the most common conditions affecting quality of life. The aim of this study was to assess people’s beliefs regarding the impact of, and changes in the prevalence of, persistent cough in the Italian general population over a 10-year time period. Methods: Two telephone surveys were conducted in 2006 and 2015, and the answers were compared. In 2015, the same questionnaire was also randomly distributed in paper form to another cohort. Sample sizes were precalculated for their representativeness and comparability (Chi-square test). Results: In total, 1,251 subjects in 2015 and 1,334 in 2006 completed the interviews. The corresponding completion rate for the interviews was 23.0% and 21.8%, respectively; 5,056 individuals completed the paper-form questionnaire. A substantial proportion of respondents stated that persistent cough should be regarded as a disease and not merely as a symptom. This belief increased from 38.8% to 46.4% (p<0.03) over the study decade. The prevalence of persistent cough recorded through computer-assisted telephone interview was 14.2% and 18.4% in the 2006 and 2015 surveys, respectively (p<0.02), and 35.5% in individuals answering the paper-form questionnaire (p<0.01). General practitioners (69.6%) and lung physicians (16.2%) were among the most frequently consulted medical professionals for cough. The majority of respondents disagreed with first-line antibiotic and/or systemic steroid use, while antitussive drugs and mucolytics were highly valued. The willingness of the patient to pay for their own treatment increased, with >40% of responders willing to pay >€10 at the pharmacy in 2015. Conclusion: These surveys showed the prevalence of persistent cough is increasing, together with the willingness of the patient to pay out of their own pocket for treatment. However, the methodology for data collection should be carefully considered before data are generalised.