Abstract

Background: Current ERS/ACCP guidelines recommend a range of treatments for chronic cough (CC), but it is unclear how effective these are at improving subjective cough outcome in clinical practice.

Objective: To evaluate the effectiveness of guideline recommended treatment for CC on patient reported outcomes (PROs).

Methods: Prospective observational single center cohort study. Treatments were based on recent ERS guideline. CC assessments included Leicester Cough Questionnaire (LCQ), cough severity visual analogue scale (VAS), and patient perception of treatment response using the Global Rating of Change (GROC).

Results: 69 patients with CC (49 females; mean (S.D) age, 55.7±14.5yrs, cough duration 7yrs, VAS 62.33mm(22.96), LCQ 10.55(3.36)) were recruited. 33 patients reported no benefit, while 36 patients reported important improvement on the GROC. Of these, 10 reported an improvement between a ?tiny bit better? and ?somewhat better?. 26 patients scored between ?moderately better? and ?a very great deal better?. Mean LCQ change varied (0.35 to 9.85), VAS scores ranged (-1.0mm to -58.0mm). Mean values and responder groups achieving MID for LCQ and VAS across GROC responses are reported.

Conclusions: Guideline-based treatments improved cough PROs in only half the patients with CC. The magnitude of effect was highly variable across GROC items but higher than MID thresholds were observed for ?moderately better? or greater.