Chronic cough – assessment of treatment efficacy based on two questionnaires

Abstract

IntroductionEfficacy of chronic cough treatment is ambiguous. The aim of the study was to analyze chronic cough alleviation after specific treatment and the relationship between cough etiology and treatment efficacy.Material and methodsA stepwise diagnostic approach was used to diagnose cough etiology in non-smoking adults with chronic cough. In all patients specific treatment was applied. Two different questionnaires – a visual analog scale and a 5-degree scale – were used to assess cough severity before and after 4-6 months of treatment.ResultsA significant correlation between pre-treatment and post-treatment results of both questionnaires was found (Spearman coefficient 0.43, p = 0.0003 and 0.73, p < 0.0001, respectively). Baseline questionnaire analysis revealed no differences in cough severity between patients with different cough causes or multiple cough causes. Although specific treatment resulted in a significant decrease of cough severity in the entire group, only partial improvement was noted. According to the visual analogue scale, a decrease of cough severity by at least 50% was achieved only in 54.4% of patients (37/68). Similarly, satisfactory improvement was noted in only 54.4% (37/68) of patients when using the 5-point scale. There were three sub-groups of patients, in whom no relevant decrease of cough severity was observed despite treatment: patients with 1. three coexisting cough causes, 2. non-asthmatic eosinophilic bronchitis, and 3. chronic idiopathic cough.ConclusionsCough severity does not depend on its etiology. Efficacy of chronic cough treatment in non-smoking patients is only moderate.

Classification of Cough as a Symptom in Adults and Management Algorithms

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CTGF upregulation correlates with MMP-9 level in airway remodeling in a murine model of asthma

“…Asthma is a common disease of children and is one of the most common causes of chronic cough in adult non-smokers, characterized by the presence of increased numbers of activated mast cells and eosinophils in the airway [ 1 , 2 ]. In addition to the presence of inflammatory cells in the airway, the airways demonstrate varying levels of structural changes termed airway remodeling [ 3 , 4 ].…”

Speech Therapy—A Non-Pharmacological Method to Manage Difficult-to-treat Chronic Cough

“…Therefore, the effective therapies for CC are one of the most important unmet needs in respiratory diseases. The effectiveness of CC management, however, is highly unsatisfactory [3,11,12]. In the study by Haque et al [3] 42% of patients with CC did not improve despite causal treatment.…”

“…Our previous study showed that only 55% of patients with CC reported significant decrease in cough severity as a result of applied therapy [11]. Similarly, in the recently published survey study approximately 36% of patients with CC declared no effect of cough therapy [12]. According to the ACCP guidelines, persistent untreatable cough refers to 5-10% of all CC patients undergoing treatment and up to 46% of patients managed in specialised cough clinics [4].…”