P107 Time to re-group: a novel approach to the delivery of speech and language therapy for chronic refractory cough

Abstract

IntroductionSpecialist speech and language therapy (SLT) has an important role in the treatment of chronic refractory cough (CRC). Therapy is typically delivered to patients individually; however, this approach is resource-intensive and reduces service capacity. Moreover, the content of SLT for CRC is often similar across patients. The aim of this work was to describe the efficacy of a SLT-delivered cough therapy group (CTG).MethodologyEligible patients attended the CTG (2016–2017) after an initial 1:1 assessment to determine suitability. Individuals with an infectious cause of cough were excluded. All patients had undergone prior assessment and treatment optimisation at the RBH chronic cough clinic. Cough severity was rated using a visual analogue scale (VAS) at first attendance and on discharge from the group. Patients attended a maximum of four sessions with 4–8 patients per session, after which they were referred for individual review if they felt no improvement had been made. CTG sessions consisted of strategies to reduce cough frequency (through improved upper airway lubrication, reduction of laryngeal muscle strain and use of cough control strategies), sharing experiences, observing other patient-therapist interactions and time to talk individually with the SLT.ResultsNinety-one patients (n=26 males, 28.6%) aged between 30 and 83 years (M=61.4, SD 11.1) attended CTG. The majority of attendees (n=46, 50.5%) reported cough duration of greater than 15 years. There was a reduction in mean VAS following group attendance (p<0.05) (figure 1) with the greatest reduction noted after 3 attendances (p<0.05). The most common patient-reported benefits of group attendance were sharing advice (80.2%) and meeting other people with a cough (76.9%).Abstract P107 Figure 1Mean VAS scores of cough severity pre- and post-CTG attendance.ConclusionA group-delivered SLT treatment intervention was associated with reduction in cough severity in a cohort of patients with CRC. Service benefits included reduced waiting time and improved access to individual SLT sessions. Future work should focus on qualitative analysis of patient-reported benefits of group therapy and evaluation of efficacy in a prospective, randomised study.

Non-pharmacological interventions for chronic cough: The past, present and future

“…Others have started to explore the use of group classes instead of individual classes and found group classes to be beneficial however as yet these have only been presented as abstracts at conferences and there have been no comparative studies of classes versus individual treatment (Selby et al, 2017;Selby et al 2018).…”