Overall, the results of this consumer study demonstrate that over half of the respondents experienced throat discomfort or irritation in the past 12 months. The common cold/influenza was perceived to be the most common cause of throat discomfort across the countries surveyed although environmental and physical factors were also major perceived causes. Infections with bacteria/viruses and the common cold/influenza were classified as causing the highest degree of suffering across the countries. The descriptors used by respondents to indicate how their throat felt were similar across the countries and were dependent on the perceived cause of throat discomfort. The emotional impact and general attitude towards illness were similar across all countries as was the action taken in relation to the cause.
These data demonstrate that, in the mind of the consumer, throat irritation and discomfort may have a variety of perceived causes that can be broadly divided into three categories: the first category being caused by infections (e.g. caused by cold/influenza, bacterial/viral infection), the second being caused by environmental factors (e.g. allergy/hay fever, passive smoking, pollution, temperature, etc.), and the third a result of self-induced/physical factors (e.g. smoking, drinking, shouting, etc.).
Although infection was the most commonly reported cause of throat discomfort on an individual basis, when environmental factors were pooled these led to a higher overall frequency of illness. For example, respondents in Malaysia (a tropical country) reported that a high frequency of symptoms were caused by pollution, dust and outdoor conditions, and sudden changes in temperature, which could be linked with more time spent outdoors in a drier environment. This finding indicates that there is a degree of seasonality with regard to the perceived cause of throat discomfort: infection and allergy, such as hay fever, may be regarded as seasonal causes, whereas environmental causes may be regarded as non-seasonal.
The high incidence of throat discomfort in Poland was likely to be a result of seasonality, as the survey was conducted during November when the weather would have been colder and as such, sore throat may have been at the forefront of respondents’ minds, rather than indicating a higher incidence of throat discomfort per se. In Poland there can also be a large contrast between overheated public places, offices and shops, and the cold outdoors. Throat discomfort due to air conditioning is more frequently mentioned in France, where usage is higher due to seasonal high temperatures. Pollution is also frequently mentioned in Malaysia and France, which may be linked to pollution levels in Kuala Lumpur and Paris.
When asked about their treatment approach to illness and medication, most respondents stated that they ‘tend to see how symptoms develop and if they don’t disappear quickly, I take the appropriate medication’; although in all countries there were some respondents that would take appropriate medication as soon as symptoms appeared. This does indicate that there are differences in treatment approaches between consumers when it comes to their health. It has been previously reported that most people with sore throat do not seek medical help
]. The treatment that was selected tended to differ depending on the perceived cause of the throat discomfort. Those with symptoms attributed to bacterial/viral infection or cold/influenza were most likely to use medicated products, hot drinks, throat sweets, or to consult a GP, although medical consultations are sought for other perceived causes. Symptoms that were a result of other causes were treated with a range of remedies including hot and/or cold drinks for those caused by hot and dry conditions, dust, air conditioning, or temperature changes; medicated products or throat sweets were generally used for irritation resulting from talking/shouting. Medicated lozenges were taken across multiple perceived causes of throat discomfort and across all countries; however, medicated lozenges may not always be appropriate for non-infectious causes of sore throat as they may contain local disinfectants to specifically target infectious agents.
The approach of respondents to treatment reflected the severity and perceived cause of their throat discomfort and irritation. Almost half of respondents waited a short time before seeking treatment, but around one-third had a treat early mentality, seeking treatment immediately upon experiencing symptoms. Throat discomfort that was rated as being most severe (i.e. that caused by infection or allergy) was typically treated using medicated products. More severe symptoms caused by environmental factors were treated using hot/cold drinks or confectionery. The use of products with a sensorial effect, i.e. warming or cooling, indicates specific needs from consumers. Those sore throats that were considered least severe were treated with a wider range of approaches.
Based on the descriptors and severity scores provided by respondents, throat discomfort and irritation caused by environmental factors was considered only slightly less severe than that caused by infection. Also, environmental and physical causes of throat discomfort affected respondents throughout the year and the ongoing and cumulative impact of such suffering may be significant. Furthermore, all types of throat irritation were reported to have an impact on the ability of respondents to function normally, except in 16% of cases. Responses were similar across all the countries assessed and in some cases the effect was so severe that respondents claimed to feel down/depressed or unsociable, demonstrating an emotional impact.
Based on these data, three distinct forms of treatment were sought depending on the perceived cause, the severity of symptoms, and the need of the consumer. Some wanted medicinal products, presumably for stronger relief of sore throat symptoms. Others wanted products with a more sensorial feel, be that cooling or warming drinks or soothing lozenges, while others sought early treatment, perhaps to prevent the condition getting worse. There were also a proportion of respondents who did not seek treatment. This is likely to be reflective of the individual and personal nature of throat discomfort, and how illness is perceived by the respondent.
As described above, however, environmental factors led to symptoms that were considered to be almost comparable in severity to symptoms caused by infection. The low uptake of medicated products among sufferers of some physical or environmental symptoms is, therefore, surprising as these respondents must suffer significant discomfort and reductions in quality of life. If patients seek help from pharmacists and other healthcare professionals, they should recommend the most suitable and effective medicated products to deliver the relief the patient is seeking at that time – treatment should be tailored to manage the patient’s throat discomfort based not only on its cause, but also on the patient’s expectations of treatment. Previous studies have shown that patients who consult their GP with a sore throat are looking for pain relief rather than an antibiotic prescription
]. There may also be a need to educate sufferers regarding the most effective management of their throat discomfort or irritation as antibiotics may often be inappropriately prescribed for sore throat as a result of patient pressure
Limitations of this study include the different demographic data available across the countries, which makes direct comparisons across the countries difficult. Although, the demographic data are different, they are still representative of each country. Also, the lower internet penetration in Malaysia at the time of the online survey may have led to a bias towards younger age groups, professionals/full-time employees, and city locations.