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Chronic cough: An exploration of impact and an evaluation of non-pharmacological management in adults

Chamberlain Mitchell, Sarah Ann Frances

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Authors

Sarah Ann Frances Chamberlain Mitchell



Abstract

Chronic cough is defined as a cough that lasts for greater than 8 weeks in duration and has been estimated to have a prevalence of 11-13% of the population. Limited research has been conducted exploring its impact on the wider community. In up to 42% of chronic cough cases, the cough persists despite medical management, these cases tend to be labelled as refractory chronic cough. Pharmacological treatments are limited often with undesirable side effects. Research into non-pharmacological treatments for refractory chronic cough has been limited.

An internet based European survey explored the impact of chronic cough (January 2012 - April 2013). A systematic review investigated the effectiveness of non-pharmacological interventions for refractory chronic cough. A single blinded multi-centre randomised controlled trial (RCT) investigated the efficacy of a non-pharmacological intervention (Physiotherapy, Speech and Language Therapy Interventions, - PSALTI) on cough related quality of life (QoL), cough frequency, severity, sensitivity, vocal performance, anxiety and depression alongside a control intervention.

In total 1120 responses were collected and analysed from the European survey. Findings identified that cough impacted upon QoL, mood and ability to undertake activities and limited/ no effectiveness of medication; also a wish for more patient information to be available.

PSALTI trial showed statistically significant differences between groups for the outcomes; QoL, cough frequency and urge to cough, improvements were significantly greater in the PSALTI group compared with control. There were no significant changes in outcomes from 4 weeks to 3 months suggesting that observed improvements were maintained.

This thesis has identified the impact of chronic cough in Europe. It identified the need to improve the management of chronic cough and the information available for patients. This thesis also provides the first evidence within a single blinded multi-centre RCT that PSALTI is an effective treatment option for people with refractory chronic cough.

Citation

Chamberlain Mitchell, S. A. F. (2016). Chronic cough: An exploration of impact and an evaluation of non-pharmacological management in adults

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