Development and validation of the mayo clinic cough hypersensitivity questionnaire for cough hypersensitivity syndrome

SESSION TITLE: Cough: Nothing to Sneeze About SESSION TYPE: Rapid Fire Original Inv PRESENTED ON: 10/10/2023 12:00 pm - 12:45 pm PURPOSE: Patients with refractory chronic cough (RCC) often have hypersensitivity of the cough reflex pathway manifesting as hypertussia, allotussia and an urge-to-cough sensation from the throat area. This entity has been labelled as cough hypersensitivity syndrome (CHS). The signs and symptoms necessary to diagnose CHS in patients with RCC remain unclear. In addition, the proportion of RCC patients who present with hypertussia and allotussia features is also unclear. The goal of the present study was to study the prevalence of CHS symptoms in a cohort of RCC patients and to develop and validate a CHS-focused chronic cough questionnaire; the Mayo Clinic Cough Hypersensitivity Questionnaire (MACHS-Q). METHODS: Patients participating in the MACS-1trials (NCT05110144) were administered the MACHS-Q questionnaire comprising of 3 sections. 1) triggers for cough using a 5-point Likert scale. 2) abnormal urge-to-cough throat &chest sensations and 3) quality of life and activities avoided by patients secondary to cough. RESULTS: A total of 27 patients completed the questionnaire. The most common triggers for cough were laughing (100%), talking (96.2963%), change in body position (96.2963%), singing (92.5926%), strong smells (92.5926%), deep breathing (88.8889%), cold air (88.8889%), changes in air temperature (85.1852%), exercise (85.1852%), changes in humidity (85.1852%), household cleaners (81.4815%) and fumes of any kind (81.4815). An urge-to-cough from the throat area was reported in 96.3% of patients. This throat sensation was described as “tickling” (61.54%), “irritating” (53.85%), “scratching”, and “feeling of something stuck in the throat” (50%), “scratching” (42.3%), dripping(38.46%) and feeling of lump in throat (38.46%). Activities that improved the urge-to-cough sensation included taking sips of water (65.38%), avoiding talking (61.53%) and using throat lozenges (61.53%). An urge-to-cough from the chest area (distinct from the throat area) was reported by 40.7% of patients and described as “tightness of the chest” (54.54%) and “chest irritation” (54.54%). Activities that were avoided because of coughing included: singing and public speaking (77.78%), talking(74.07%), exposure to strong smells (70.37%), exercising (62.96%), and eating in restaurants (51.85%). 48.14% of patients reported changes in voice secondary to coughing with transient hoarseness being the most reported (100%), followed by raspy voice in 92.3%, loss in strength of voice as the day progresses (69.23%) , cracking (92.3%), noisy breathing( 61.53%) and partial or complete loss of voice in 46.15%. CONCLUSIONS: We report preliminary findings from the development of the MACHS-Q. Further item reduction and validation of the instrument is ongoing. The various dimensions of the MACHS-Q may be beneficial in the identification of patients with CHS and may provide a measure of CHS severity and proper identification of patients for neuromodulatory therapies. CLINICAL IMPLICATIONS: The MACHS-Q is being developed as a possible tool to screen patients for cough hypersensitivty syndrome and has the potential to be used clinically in the future when validated. DISCLOSURES: No relevant relationships by Joshika Agarwal No relevant relationships by Vibhor Ahluwalia No relevant relationships by Vaibhav Ahluwalia No relevant relationships by Sumera Ahmad No relevant relationships by Hasan Ahmad Hasan Albitar No relevant relationships by Shivam Damani No relevant relationships by Sue Donlinger No relevant relationships by Sue Donlinger No relevant relationships by Ashley Egan No relevant relationships by Sumedh Hoskote No relevant relationships by Vivek Iyer No relevant relationships by Kinnera Jalagam monograph relationship with BMJ Please note: $1-$1000 by Karina Keogh, value=Honoraria Site PI for pharmaceutical trial relationship with AstraZeneca Please note: 2022 by Karina Keogh, value=Site PI for pharmaceutical tri Educational grant relationship with GSK/Potomac Center for Medical Education (PCME), Please note: 2019-2020 by Karina Keogh, value=Travel No relevant relationships by Kaiser Lim No relevant relationships by Ashokakumar Patel No relevant relationships by Shivaram Poigai Arunachalam No relevant relationships by Nanditha Venkatesan No relevant relationships by Kathleen Yost