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Bakgrund: Kronisk hosta är ett vanligt medicinskt tillstånd och definieras som hosta som varar mer än åtta veckor och är behandlingsresistent (refraktär) trots noggranna utredningar eller medicinska behandlingar. Det drabbar cirka 10% av den vuxna befolkningen och har en betydande negativ inverkan på livskvalitet. Det finns hittills inga studier som beskriver hur hostan påverkar individernas vardag och möjlighet att genomföra fysisk aktivitet. Syfte: Att undersöka hur individer som har diagnostiserats med kronisk refraktär hosta upplever att hostan påverkar vardagen och hens förmåga att vara fysisk aktiv.  Metod: Kvalitativ metod med semistrukturerade intervjuer tillämpades. Intervjuerna (n=10) transkriberades och tolkades med tematisk analys med induktiv ansats.  Resultat: Analysen resulterade i tre huvudteman 1) Betydande inverkan på vardagen, 2) Kampen om kontrollen och 3) Hostan under fysisk aktivitet. Dessa tre teman och deras åtta underteman belyser komplexiteten och omfattningen av hur hostan påverkar individernas liv. Slutsats: Kronisk hosta har avsevärd påverkan på vardagen och har negativa effekter på individens psykosociala tillstånd. Studien belyser dock att fysisk aktivitet är genomförbart för individer med kronisk hosta men att anpassningar kan behövas avseende intensitet eller typ av aktivitet. En bättre förståelse för innebörden och konsekvenserna av att leva med kronisk hosta kan vara ett bidrag till att ytterligare utveckla framgångsrika behandlingsmetoder. / Background: Chronic cough is a common medical condition and is defined as cough that lasts more than eight weeks and is treatment-resistant (refractory) despite careful investigations or medical treatments. It affects about 10% of the adult population and has a significant negative impact on quality of life. So far, there are no studies describing how the cough affects individuals' everyday lives and ability to carry out physical activity. Aim: To investigate how individuals who have been diagnosed with chronic refractory cough experience that the cough affects everyday life and his/her ability to be physically active. Method: Qualitative method with semi-structured interviews was applied. The interviews (n=10) were transcribed and interpreted with thematic analysis with an inductive approach. Results: The analysis resulted in three main themes: 1) Significant impact on everyday life, 2) The struggle for control and 3) The cough during physical activity. These three themes and their eight subthemes highlight the complexity and scope of how the cough affects the lives of individuals. Conclusion: Chronic cough has a significant impact on everyday life and has negative effects on the individual's psychosocial state. However, the study highlights that physical activity is feasible for individuals with chronic cough but that adaptations may be needed regarding intensity or type of activity. A better understanding of the meaning and consequences of living with chronic cough can be a contribution to further developing successful treatment methods.

Introduction: Cough is the commonest reason for which medical advice is sought. In assessment of chronic cough and in developing anti-tussive medications, inhalational cough challenges with capsaicin and citric acid are commonly employed. However the ability of these inhalational cough challenges to distinguish health and disease is not clear and it is not known which end point is best in making such assessments. Methods: Subjects belonging to five different categories (healthy volunteers, subjects with COPD, asthma, healthy current smokers and chronic cough) were compared with each another by using the standard cough challenges employing Capsaicin and Citric acid and also by using newer inhalational cough challenge agents such as prostaglandin E2 and bradykinin. In addition adaptation to repeated inhalations of tussive agents was also assessed. The relationship between the cough reflex sensitivity as gauged by using inhalational cough challenge tests and objective cough recording was explored in all five groups. Finally the change in C5 in Capsaicin evoked cough by using a substance to block TRPV1 channel and its effect on objective cough recording was assessed in subjects with chronic cough. Results: Different tussive agents have different abilities to distinguish between different diagnostic categories and a combination of inhalational cough challenge tests have a better accuracy of predicting diagnostic groups as compared to one on its own. There are significant differences in the rates of adaptation to repeated inhalations of PGE2 and there is a significant reduction in cough response over period of time in all disease groups. Using the TRPV1 antagonist resulted in a modest increase in the Log C5 concentration of capsaicin but this was not matched by a change in objective cough recording or CQLQ scores. Conclusions: The different abilities of tussive agents to distinguish between different diagnostic categories suggest that the information conveyed by the one inhalational cough challenge test is different from that by another test. The choice of the inhalational cough challenge test should therefore depend on which groups are included in the study. There was no significant difference in the rate of adaptation to prolonged challenge with citric acid or capsaicin and no significant correlation of the magnitude of adaptation with objective cough recording suggesting that this is unlikely to be responsible for the increased cough rates seen in diseases such as chronic cough, COPD or asthma. The TRPV1 antagonist did not result in a significant change in objective cough recording or CQLQ scores. The change in C5 with the TRPV1 antagonist was however modest and this may be reason for this study failing to show a relationship between these different measures.

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