| Description |
Chronic refractory cough (CRC) is a cough of unknown etiology persisting for 8 weeks or longer. The cough hypersensitivity syndrome model proposes that CRC results from a reduced cough reflex threshold triggered at the sensory receptor level, or at the brainstem level. The two most common approaches for treating CRC include pharmaceutical or behavioral approaches. Both treatment approaches demonstrate effective short-term outcomes up to 4 weeks posttreatment. However, long-term outcomes are unknown. This study investigated long-term treatment outcomes in those with CRC evaluated at the University of Utah Voice Disorders Center from January 1, 2016, to June 1, 2018. Participants under 6 months posttreatment who did not complete the Leicester Cough Questionnaire (LCQ) pretreatment, and had pulmonary disease were excluded. Consented participants completed a telephone interview regarding self-report of behavioral and pharmaceutical treatment adherence and benefit, and the LCQ. A total of 80 individuals meeting inclusion criteria were recruited, and 29 consented to participate. The mean age of participants was 57.8 years (SD + 12.1); 20 were female and nine were male. Of these, 25 were recommended to complete behavioral treatment alone, two behavioral plus pharmaceutical treatment, and two were recommended neither behavioral nor pharmaceutical treatment. All participants recommended behavioral treatment were stratified into one group, due to inadequate representation across groups. In those iv recommended behavioral treatment (n = 27), there was a significant increase in LCQ total scores from pretreatment to long-term posttreatment by 4.4 (SD + 4.2; p < 0.0001). During the telephone interview, 72% reporting behavioral treatment indicated completion of most or all of behavioral treatment recommendations, and 56% indicated improvement or elimination of cough. The outcomes of this study demonstrate a significant improvement in long-term posttreatment LCQ total scores in those recommended behavioral treatment as well as overall adherence to treatment recommendations with slightly more than half indicating improvement or elimination of cough. These findings lend further support toward the benefit of behavioral management of CRC. Future research would benefit from a prospective randomized control trial to test pharmaceutical treatment effect on CRC, in order to test the underlying mechanism of hypersensitive cough reflex. |
