WAO-ARIA consensus on chronic cough – Part III: Management strategies in primary and cough-specialty care. Updates in COVID-19

Rouadi, Philip W.; Idriss, Samar; Bousquet, Jean; Laidlaw, Tanya M.; Azar, Cecilio; Al‐Ahmad, Mona; Yáñez, Anahí; Al‐Nesf, Maryam; Nsouli, T.; Bahna, Sami L.; Abou-Jaoude, Eliane; Zaitoun, Fares; Hadi, Usamah M.; Hellings, Peter; Scadding, Glenis K.; Smith, Peter; Morais‐Almeida, Mário; Gómez, René Maximiliano; Díaz, Sandra Nora González; Klimek, Ludger; Juvelekian, Georges; Riachy, Moussa; Canonica, Giorgio Walter; Peden, David B.; Wong, Gary; Sublett, James; Bernstein, Jonathan A.; Wang, Lianglu; Tanno, Luciana Kase; Chikhladze, Manana; Levin, Michael; Chang, Yoon‐Seok; Martin, Bryan; Caraballo, Luis; Čustović, Adnan; Ortego-Martell, Jose Antonio; Lesslar, Olivia J.Ly; Jensen‐Jarolim, Erika; Ebisawa, Motohiro; Fiocchi, Alessandro; Ansotegui, Ignacio J.

doi:10.1016/j.waojou.2022.100649

Cited by 9 publications

(6 citation statements)

References 203 publications

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“…Not only was the prevalence of these conditions still elevated 8.5-9 years after the fire, they also appeared to increase over time. Chronic cough is associated with deteriorations in physical, mental and social health (32), and treatments are limited and complex (33). Therefore, these findings are a concerning development for our cohort and others around the world who have been exposed to extreme smoke events.…”

Section: Discussionmentioning

confidence: 99%

Respiratory symptoms after coalmine fire and pandemic: a longitudinal analysis of the Hazelwood Health Study adult cohort

Lane,

Carroll,

Borg

et al. 2023

Preprint

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Background Extreme but discrete fine particle <2.5μm (PM2.5) exposure is associated with higher prevalence of respiratory symptoms. It is unknown whether these effects abate, persist, or worsen over time, nor whether COVID-19 exacerbates PM2.5effects. Methods We analysed longitudinal survey data from a cohort residing near a 2014 coalmine fire in regional Australia. A 2016/2017 survey included n=4,056 participants, of whom n=612 were followed-up in 2022. Items include questions about 7 respiratory symptoms, history of COVID-19, and time-location diaries that were combined with geospatial models of fire-related PM2.5. Associations were examined using logistic and mixed-effects logistic regressions. Results PM2.5exposure predicted higher prevalence of chronic cough and current wheeze 2-3 years post-fire. At the 2022 follow-up, PM2.5exposure was associated with worsening prevalence of chronic cough and possibly current wheeze. While were no detectable interaction effects between PM2.5and COVID-19, participants with a history of COVID-19 exhibited more significant associations between PM2.5exposure and respiratory symptoms. Discussion Short-term but extreme PM2.5may increase the long-term prevalence of chronic cough, while COVID-19 may exacerbate the effect on other respiratory symptoms.

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Section: Discussionmentioning

confidence: 99%

Respiratory symptoms after coalmine fire and pandemic: a longitudinal analysis of the Hazelwood Health Study adult cohort

Lane,

Carroll,

Borg

et al. 2023

Preprint

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“…In addition, we observed that 37.7% of CC patients had ≥1 pulmonologist visit, 23.2% had ≥1 gastroenterologist visit, 12.7% had ≥1 otolaryngologist visit, which were substantially higher than those without CC (7.1%, 8.3%, 4.0%, respectively). Management of CC requires an interdisciplinary approach involving primary and specialty care [54,55]. Primary care physicians (PCPs) can play an important role in providing the initial diagnostic assessment of CC patients as well as trials of empirical therapies for potential underlying causes.…”

Section: Discussionmentioning

confidence: 99%

Patterns of Cough Medication Prescribing among Patients with Chronic Cough in Florida: 2012–2021

Yang,

Huang,

Hincapie-Castillo

et al. 2023

JCM

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Among patients with chronic cough (CC) in the 2012–2021 statewide OneFlorida Clinical Research Consortium database, we examined trends in cough medication (CM) prescribing prevalence over time in repeated cross-sectional analyses and identified distinct CM utilization trajectories using group-based trajectory modeling (GBTM) in a retrospective cohort study. Among eligible adults (≥18 years) without cancer/benign respiratory tumor diagnoses, we identified CC patients and non-CC patients with any cough-related diagnosis. In the GBTM analysis, we calculated the number of monthly prescriptions for any CMs (excluding gabapentinoids) during the 12 months from the first qualifying cough event to identify distinct utilization trajectories. From 2012 to 2021, benzonatate (9.6% to 26.1%), dextromethorphan (5.2% to 8.6%), and gabapentinoid (5.3% to 14.4%) use increased among CC patients, while opioid antitussive use increased from 2012 to 2015 and decreased thereafter (8.4% in 2012, 14.7% in 2015, 6.7% in 2021; all p < 0.001). Of 15,566 CC patients and 655,250 non-CC patients identified in the GBTM analysis, CC patients had substantial burdens of respiratory/non-respiratory comorbidities and healthcare service and concomitant medication use compared to non-CC patients. Among CC patients, GBTM identified three distinct CM utilization trajectories: (1) no CM use (n = 11,222; 72.1%); (2) declining CM use (n = 4105; 26.4%); and (3) chronic CM use (n = 239; 1.5%). CC patients in Florida had limited CM use with increasing trends in use of benzonatate, dextromethorphan, and gabapentinoids and a decreasing trend in opioid antitussive use. CC patients, particularly with chronic prescription CM use, experienced substantial disease burden.

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“…Current international guidelines on chronic cough have recommended treating cough as per its related aetiologies (e.g., asthma, GORD, etc.) and/or non-specific antitussive treatments (i.e., potentially using neuromodulators and ATP antagonists for cough hypersensitivity; ICS for eosinophilic inflammation) [36,41,102,103] rather than basing it on the presence of phlegm (i.e., dry cough or productive cough/chronic bronchitis). This is probably because earlier studies have shown that the presence of phlegm provides little value to indicate the potential aetiologies of a cough [9,102,104].…”

Section: Cb In Adults: Prevalence Risk Factors and Consequencesmentioning

confidence: 99%

Chronic Bronchitis in Children and Adults: Definitions, Pathophysiology, Prevalence, Risk Factors, and Consequences

Zhang,

Wurzel,

Perret

et al. 2024

JCM

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The complex nature of chronic bronchitis (CB) and changing definitions have contributed to challenges in understanding its aetiology and burden. In children, CB is characterised by persistent airway inflammation often linked to bacterial infections and is therefore termed “protracted bacterial bronchitis” (PBB). Longitudinal studies suggest that CB in childhood persists into adulthood in a subgroup. It can also be associated with future chronic respiratory diseases including asthma, bronchiectasis, and chronic obstructive pulmonary disease (COPD). Adult CB is traditionally associated with smoking, occupational exposures, and lower socioeconomic status. The interplay between risk factors, childhood CB, adult CB, and other chronic respiratory diseases is intricate, requiring comprehensive longitudinal studies for a clearer understanding of the natural history of CB across the lifespan. Such longitudinal studies have been scarce to date given the logistic challenges of maintaining them over time. In this review, we summarise current evidence on the evolution of the definitions, pathophysiology, risk factors, and consequences of childhood and adulthood chronic bronchitis.

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WAO-ARIA consensus on chronic cough – Part III: Management strategies in primary and cough-specialty care. Updates in COVID-19

Cited by 9 publications

References 203 publications

Respiratory symptoms after coalmine fire and pandemic: a longitudinal analysis of the Hazelwood Health Study adult cohort

Respiratory symptoms after coalmine fire and pandemic: a longitudinal analysis of the Hazelwood Health Study adult cohort

Patterns of Cough Medication Prescribing among Patients with Chronic Cough in Florida: 2012–2021

Chronic Bronchitis in Children and Adults: Definitions, Pathophysiology, Prevalence, Risk Factors, and Consequences

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