Advertisement

Lung

, Volume 186, Supplement 1, pp 17–22 | Cite as

The Current State of Cough Research: The Clinician’s Perspective

  • Louis-Philippe Boulet
Article

Abstract

Cough is one of the most common reasons for medical consultation and it is responsible for a large human and socioeconomic burden. Current guidelines provide a useful framework for cough management and summarize current knowledge of causes and optimal testing sequences and treatments of cough. However, research is needed on the role of noninvasive airway inflammation measurement in assessing etiology; optimal treatment of postinfectious cough or cough due to gastroesophageal reflux disease; protussive treatment; causes of chronic cough in immunocompromised hosts; and characteristics and management of psychogenic cough. The effects of the use or nonuse of evidence-based guidelines should be documented. An empiric, integrative approach to management of chronic cough also needs further validation.

Keywords

Chronic cough Clinical management Airway diseases Management of cough 

References

  1. 1.
    Irwin RS, Boulet LP, Cloutier MM, Fuller R, Gold PM, Hoffstein V, Ing AJ, McCool FD, O’Byrne P, Poe RH, Prakash UB, Pratter MR, Rubin BK (1998) Managing cough as a defense mechanism and as a symptom. A consensus panel report of the American College of Chest Physicians. Chest 114:133S–181SPubMedCrossRefGoogle Scholar
  2. 2.
    Irwin RS (2006) Complications of cough: ACCP evidence-based clinical practice guidelines. Chest 129:54S–58SPubMedCrossRefGoogle Scholar
  3. 3.
    Everett CF, Kastelik JA, Thompson RH, Morice AH (2007) Chronic persistent cough in the community: A questionnaire survey. Cough 3:5PubMedCrossRefGoogle Scholar
  4. 4.
    Kuzniar TJ, Morgenthaler TI, Afessa B, Lim KG (2007) Chronic cough from the patient’s perspective. Mayo Clin Proc 82:56–60PubMedCrossRefGoogle Scholar
  5. 5.
    Irwin RS, Madison JM (2002) The persistently troublesome cough. Am J Respir Crit Care Med 165:1469–1474PubMedCrossRefGoogle Scholar
  6. 6.
    Irwin RS, Baumann MH, Bolser DC, Boulet LP, Braman SS, Brightling CE, Brown KK, Canning BJ, Chang AB, Dicpinigaitis PV, Eccles R, Glomb WB, Goldstein LB, Graham LM, Hargreave FE, Kvale PA, Lewis SZ, McCool FD, McCrory DC, Prakash UB, Pratter MR, Rosen MJ, Schulman E, Shannon JJ, Smith HC, Tarlo SM, American College of Chest Physicians (2006) Diagnosis and management of cough executive summary: ACCP evidence-based clinical practice guidelines. Chest 129(1 Suppl):1S–23SPubMedCrossRefGoogle Scholar
  7. 7.
    Morice AH, Fontana GA, Belvisi MG, Birring SS, Chung KF, Dicpinigaitis PV, Kastelik JA, McGarvey LP, Smith JA, Tatar M, Widdicombe J, European Respiratory Society (2007) ERS guidelines on the assessment of cough. Eur Respir J 29:1256–1276PubMedCrossRefGoogle Scholar
  8. 8.
    Committee for the Japanese Respiratory Society Guidelines for Management of Cough, Kohno S, Ishida T, Uchida Y, Kishimoto H, Sasaki H, Shioya T, Tokuyama K, Niimi A, Nishi K, Fujimura M, Matsuse H, Suzaki H (2006) The Japanese Respiratory Society guidelines for management of cough. Respirology 11(Suppl 4):S135–S186PubMedGoogle Scholar
  9. 9.
    Irwin RS (2007) Guidelines for treating adults with acute cough. Am Fam Physician 75:476, 479, 482PubMedGoogle Scholar
  10. 10.
    Boulet LP (2006) Future directions in the clinical management of cough: ACCP evidence-based clinical practice guidelines. Chest 129:287S–292SPubMedCrossRefGoogle Scholar
  11. 11.
    Boulet LP, Becker A, Bowie D, McIvor A, Hernandez P, Rouleau M, Bourbeau J, Graham I, Legare F, Ward T, Cowie R, Drouin D, Harris SB, Tamblyn R, Ernst P, Tan WC, Partridge M, Godard P, Herrerias C, Wilson J, Stirling L, Rozitis EB, Garvey N, Lougheed D, Labrecque M, Rea R, Holroyde M, Fagnan D, Dorval E, Pogany L, Kaplan A, Cicutto L, Allen M, Moraca S, Fitzgerald M, Borduas F, Logan J (2006) Implementing Practice Guidelines: A workshop on guidelines dissemination and implementation with a focus on asthma and COPD. Can Respir J 13(Suppl A):5–47PubMedGoogle Scholar
  12. 12.
    Irwin RS, Madison JM (2000) The diagnosis and treatment of cough. N Engl J Med 343:1715–1721PubMedCrossRefGoogle Scholar
  13. 13.
    Chung KF (2007) Effective antitussives for the cough patient: an unmet need. Pulm Pharmacol Ther 20:438–445PubMedCrossRefGoogle Scholar
  14. 14.
    Aagaard E, Maselli J, Gonzales R (2006) Physician practice patterns: chest x-ray ordering for the evaluation of acute cough illness in adults. Med Decis Making 26:599–605PubMedCrossRefGoogle Scholar
  15. 15.
    Grol R, Grimshaw J (2003) From best evidence to best practice: Effective implementation of change in patients’ care. Lancet 362:1225–1230PubMedCrossRefGoogle Scholar
  16. 16.
    Cote J, Bowie DM, Robichaud P, Parent JG, Battisti L, Boulet LP (2001) Evaluation of two different educational interventions for adult patients consulting with an acute asthma exacerbation. Am J Respir Crit Care Med 163:1415–1419PubMedGoogle Scholar
  17. 17.
    Sigurdardottir AK, Jonsdottir H, Benediktsson R (2007) Outcomes of educational interventions in type 2 diabetes: WEKA data-mining analysis. Patient Educ Couns 67:21–31PubMedCrossRefGoogle Scholar
  18. 18.
    Members of the Workshops (2004) ARIA in the pharmacy: Management of allergic rhinitis symptoms in the pharmacy. Allergic rhinitis and its impact on asthma. Allergy 59:373–387CrossRefGoogle Scholar
  19. 19.
    Fokkens W (2007) Role of steroids in the treatment of rhinosinusitis with and without polyposis. Clin Allergy Immunol 20:241–250PubMedGoogle Scholar
  20. 20.
    Tatli MM, San I, Karaoglanoglu M (2001) Paranasal sinus computed tomographic findings of children with chronic cough. Int J Pediatr Otorhinolaryngol 60:213–217PubMedCrossRefGoogle Scholar
  21. 21.
    McGarvey LP, Heaney LG, Lawson JT, Johnston BT, Scally CM, Ennis M, Shepherd DR, MacMahon J (1998) Evaluation and outcome of patients with chronic non-productive cough using a comprehensive diagnostic protocol. Thorax 53:738–743PubMedCrossRefGoogle Scholar
  22. 22.
    American Thoracic Society (1987) Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease (COPD) and asthma. This official statement of the American Thoracic Society was adopted by the ATS Board of Directors, November 1986. Am Rev Respir Dis 136:225–244Google Scholar
  23. 23.
    Koh YY, Jeong JH, Park Y, Kim CK (1999) Development of wheezing in patients with cough variant asthma during an increase in airway responsiveness. Eur Respir J 14:302–308PubMedCrossRefGoogle Scholar
  24. 24.
    Chatkin JM, Ansarin K, Silkoff PE, McClean P, Gutierrez C, Zamel N, Chapman KR (1999) Exhaled nitric oxide as a noninvasive assessment of chronic cough. Am J Respir Crit Care Med 159:1810–1813PubMedGoogle Scholar
  25. 25.
    Lemiere C, Boulet LP (2005) Cigarette smoking and asthma: a dangerous mix. Can Respir J 12:79–80PubMedGoogle Scholar
  26. 26.
    Boulet LP, Lemiere C, Archambault F, Carrier G, Descary MC, Deschesnes F (2006) Smoking and asthma: clinical and radiologic features, lung function, and airway inflammation. Chest 129:661–668PubMedCrossRefGoogle Scholar
  27. 27.
    Irwin RS, Madison JM (2002) Diagnosis and treatment of chronic cough due to gastro-esophageal reflux disease and postnasal drip syndrome. Pulm Pharmacol Ther 15:261–266PubMedCrossRefGoogle Scholar
  28. 28.
    Wise JL, Murray JA (2007) Utilising multichannel intraluminal impedance for diagnosing GERD: A review. Dis Esophagus 20:83–88PubMedCrossRefGoogle Scholar
  29. 29.
    Dicpinigaitis PV (2004) Cough. 4: Cough in asthma and eosinophilic bronchitis. Thorax 59:71–72PubMedGoogle Scholar
  30. 30.
    Thomson NC, Chaudhuri R (2004) Why is eosinophilic bronchitis not asthma? Am J Respir Crit Care Med 170:4–5PubMedCrossRefGoogle Scholar
  31. 31.
    McCool FD, Rosen MJ (2006) Nonpharmacologic airway clearance therapies: ACCP evidence-based clinical practice guidelines. Chest 129:250S–259SPubMedCrossRefGoogle Scholar
  32. 32.
    Linz AJ (2007) The relationship between psychogenic cough and the diagnosis and misdiagnosis of asthma: A review. J Asthma 44:347–355PubMedCrossRefGoogle Scholar
  33. 33.
    Smith Hammond CA, Goldstein LB (2006) Cough and aspiration of food and liquids due to oral-pharyngeal dysphagia: ACCP evidence-based clinical practice guidelines. Chest 129:154S–168SPubMedCrossRefGoogle Scholar
  34. 34.
    Babu KS, Marshall BG (2004) Drug-induced airway diseases. Clin Chest Med 25:113–122PubMedCrossRefGoogle Scholar
  35. 35.
    Tarlo SM (2006) Cough: Occupational and environmental considerations: ACCP evidence-based clinical practice guidelines. Chest 129:186S–196SPubMedCrossRefGoogle Scholar
  36. 36.
    Menzies D, Nair A, Lipworth BJ (2006) Non-invasive measurement of airway inflammation in asthma. J Asthma 43:407–415PubMedCrossRefGoogle Scholar
  37. 37.
    Brooks SM, Weiss MA, Bernstein IL (1985) Reactive airways dysfunction syndrome (RADS). Persistent asthma syndrome after high level irritant exposures. Chest 88:376–384PubMedCrossRefGoogle Scholar
  38. 38.
    Chang AB, Newman RG, Carlin JB, Phelan PD, Robertson CF (1998) Subjective scoring of cough in children: parent-completed vs child-completed diary cards vs an objective method. Eur Respir J 11:462–466PubMedCrossRefGoogle Scholar
  39. 39.
    Chang AB, Newman RG, Phelan PD, Robertson CF (1997) A new use for an old Holter monitor: An ambulatory cough meter. Eur Respir J 10:1637–1639PubMedCrossRefGoogle Scholar
  40. 40.
    Dicpinigaitis PV (2006) Current and future peripherally-acting antitussives. Respir Physiol Neurobiol 152:356–362PubMedCrossRefGoogle Scholar
  41. 41.
    Rank MA, Kelkar P, Oppenheimer JJ (2007) Taming chronic cough. Ann Allergy Asthma Immunol 98:305–313PubMedCrossRefGoogle Scholar
  42. 42.
    Morice AH, Kastelik JA (2003) Cough. 1: Chronic cough in adults. Thorax 58:901–907PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  1. 1.Hôpital LavalQuébec CityCanada

Personalised recommendations